Background:Return to sports (RTS) is a goal for most patients who undergo anterior
cruciate ligament reconstruction (ACLR). Although it has been reported that
women RTS at a significantly lower rate compared with men, demographic and
contextual factors that may be associated with this have not been
investigated.Purpose:To compare RTS rates between men and women and investigate factors that may
be associated with different rates of RTS in an Australian context.Study Design:Cohort study; Level of evidence, 3.Methods:A total of 1338 patients who underwent primary ACLR between January 2014 and
December 2017 were invited to complete a detailed sports participation
questionnaire 2 to 7 years after surgery. RTS rates were calculated and
compared between men and women overall and after stratifying by age at
surgery (<20, 20-29, 30-39, or ≥40 years) and geographical location
(metropolitan or rural). Contingency analysis was performed to compare
factors associated with rates of RTS.Results:The survey completion rate was 81% (1080/1338). Overall, women had a
significantly lower RTS rate compared with men (65.4% vs 74.9%;P= .001). However, when patients were grouped by age,
the lower rate of RTS for women was significant only in the 20- to 29-year
age group (P= .01). For athletes who returned to sports,
there was no sex-based difference when comparing the levels of RTS. When
grouping patients based on geographical location, there was a significantly
lower rate of RTS in metropolitan-based women compared with
metropolitan-based men (P< .001) and rural-based women
(P= .042).Conclusion:Although women returned to sports at a lower rate than men overall, this
difference was predominantly seen in the 20- to 29-year age bracket and in
those who lived in metropolitan areas. There was no difference between men
and women regarding the RTS level.