Return to Sports after Multiple Trauma: Which Factors Are Responsible? - Results from a 17-Year Follow-up

Christian D. Weber, Klemens Horst, Anthony R. Nguyen, Magdalena J. Bader, Christian Probst, Boris Zelle, Hans Christoph Pape, Thomas Dienstknecht

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective: We hypothesize that the majority of polytraumatised patients are unable to maintain their preinjury level of sporting activity, and that musculoskeletal injuries are a major contributing factor. We assessed the impact of such injuries on sporting prowess, with a focus on isolating, particularly debilitating musculoskeletal trauma. Methods: We conducted a cohort study of 637 patients at a level 1 trauma centre, to assess the long-term outcome of severe trauma on return to sporting activities (RTS). Data collated on the multiply injured patient included preinjury physical activity, standardized outcome scores (SF-12, GOS, HASPOC), and clinical follow-up of at least 10 years duration. The return to preinjury sports participation was defined as a primary outcome parameter. Regression analyses were performed to identify specific injuries interfering with the RTS. Study Design: Prognostic study; Level of evidence, II. Results: Mean follow-up was 17 ± 5 years. We included 465 patients, including 207 athletic and 258 nonathletic individuals. Mean age at the time of injury was 26 ± 11.5 years and injury severity was comparable between the 2 cohorts. The deleterious effects on quality of life and the total duration of the rehabilitation process were also similar in athletes and nonathletes. Athletes were more likely to be unable to return to preinjury activities, or to return to a lower level of sporting prowess posttrauma. We identified knee injuries as the type of musculoskeletal trauma most likely to be career ending for the athlete (odds ratio 3.4, 95% confidence interval, 1.4-8.3; P = 0.008). Conclusion: Our results demonstrate an enforced shift from high-impact and team sports to low-impact activities after multiple trauma. Injuries of the lower extremities, especially around the knee joint, seem to have the highest lifechanging potential, preventing individuals from returning to their previous sporting activities.

Original languageEnglish (US)
Pages (from-to)481-486
Number of pages6
JournalClinical Journal of Sport Medicine
Issue number5
StatePublished - Sep 1 2017


  • long-term outcome
  • multiple trauma
  • rehabilitation
  • return to sports
  • sports activity

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine


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