Epidemiology of Anterior Cruciate Ligament Tears in National Collegiate Athletic Association Athletes: 2014/15 – 2018/19

Abstract

Anterior cruciate ligament (ACL) tears are prevalent in National Collegiate Athletic Association (NCAA) sports, and updated epidemiological evidence is needed to adequately inform prevention efforts. Purpose To describe the epidemiology of ACL tears in NCAA men’s and women’s sports. Methods Injury and exposure data collected within the NCAA Injury Surveillance Program from 2014/15-2018/19 were analyzed. ACL tear frequencies, rates (IRs) and proportions were used to describe injury incidence by sport, event type, injury mechanism, and injury history. Injury rate ratios (IRRs) were utilized to examine differential injury rates, and injury proportion ratios (IPRs) were used to examine differential distributions. Results A total of 729 ACL tears were reported from 8,474,401 recorded athlete exposures (AEs) during the study period (IR = 0.86 per 10,000 AEs), and the competition-related ACL tear rate was higher than the practice-related rate (IRR = 5.52, 95% CI: [4.75, 6.39]). Among men’s sports, the highest overall ACL tear rate was observed in men’s football (IR = 1.44 per 10,000 AEs), while among women’s sports, the highest overall rate was observed in women’s soccer (IR = 2.60 per 10,000 AEs). Among sex-comparable sports, ACL tear rates were higher in women’s basketball, softball, and soccer, as compared with their men’s counterparts. ACL tears were more prevalently attributed to player-contact mechanisms in men’s sports than women’s sports (IPR = 1.73, 95% CI: [1.37, 2.19]), while more prevalently attributed to non-contact mechanisms in women’s sports than men’s sports (IPR = 1.17, 95% CI: [1.01, 1.35]). Conclusions ACL tear risk in women’s sports continues to warrant attention and prevention efforts. Given the differential rates by event type, future research efforts may also evaluate initiatives to reduce competition-related injury burden in NCAA sports.

A Pilot Survey Study of Anterior Cruciate Ligament Injuries in Female University Athletes

“…A significant limitation of this study was selection bias: one can speculate that participants were much more likely to respond to the survey if they had suffered a previous knee injury. This explains the disproportionately high prevalence of knee injuries (42%) within our participant pool, which is significantly higher than previously reported [28]. One would need to sample this population more randomly to better assess the prevalence of STKIs in this population.…”

Effectiveness of a rehabilitation protocol after anterior cruciate ligament reconstruction in returning to match rhythm: a case study of a professional soccer player

“…Despite advancements in ACL reconstruction and rehabilitation, research suggests that only a small percentage of athletes are able to return to their pre-injury performance levels (DEWIG, 2023). Long-term consequences such as osteoarthritis are also significant considerations when planning the treatment and rehabilitation of athletes post-ACL injury (DEWIG, 2023). These findings underscore the importance of comprehensive care and ongoing support for athletes undergoing ACL reconstruction.…”

A Systematic Review of Effects on ACL Injury of Soccer Shoe Outsoles, Soccer Playing Field Surfaces, and Outsole–Surface Interface

“…A survey of the Women's Bundesliga also found that the highest prevalence of injuries among female soccer players were in the knee (31%), ankle (22.1%), thigh (12.9%), and head (7.1%) [17]. And among knee injuries, Chandran et al's [18] study of NCAA women's soccer team athletes published in 2023 further found the injury with the highest prevalence in female athletes to be ACL injuries (IR = 2.60 per 10,000 AE).…”