Oslo Sports Trauma Research Center

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Information about project titled 'Knee function of top level female team handball and football players'

Knee function of top level female team handball and football players

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Project status: Published


A significant proportion of female elite handball and football players have previously injured one or both anterior cruciate ligaments (ACL), and returned to sports after surgery and rehabilitation. ACL injuries are severe with respect to recurrent injuries and long-term consequences as an increased risk for the development of knee osteoarthritis. It is, however, uncertain whether these players are fully rehabilitated, and whether they after return to high level competition differ from the non-injured players. There is also a lack of knowledge on to which degree years of exposure to top level handball and football play influence an athlete´s knee function in general.

The Knee and Osteoarthritis Outcome Score (KOOS) is a well established and validated self-explanatory 42-item questionnaires developed to assess patient opinion about knee-associated problems after ligament reconstruction or other surgical treatment.



To investigate knee function of elite female handball and football players, with and without a previous ACL injury, and thereby assess the impact of exposure top level play do have on players´ knee function. In addition, this project is to analyze whether ACL injured players return to elite sports with side-to-side differences and/or a knee function score below that of non-injured players. 



This study is part of an ongoing cohort study aimed at investigating risk factors for non-contact ACL injuries among Norwegian elite female team sport players. Since 2007 and until June 2010, a total of 321 team handball and 246 football players (age 22±4 years) have been included; 68 (12%) of these with a previous ACL injury.

At baseline, each player was asked to complete a detailed questionnaire covering sports participation, history of previous injuries to the ankle, knee, hamstring or groin, as well as present symptoms and function of the knee. Knee function was classified using the Knee and Osteoarthritis Outcome Score (KOOS) form.

Players´ knee function will be compared between non-injured and previously ACL-injured players as well as between a non-sporty aged-matched control group. KOOS scores will also be collected for players who retired from top level play after their ACL reconstructions in the period 2007-2010.


Implications: Results from the present study will give us valuable information about elite team sport players´ knee function. Findings may influence return-to-play guidelines for ACL reconstructed athletes as well as contribute to the evaluation of players´ total exposure to top level play and training habits.