International Epidemiology of Anterior Cruciate Ligament Injuries

Abstract

The anterior cruciate ligament (ACL), the knee ligament that runs from the posterior medial aspect of the lateral femoral condyle in the intercondylar notch to the anterior aspect of the intercondylar eminence of the tibia, limits anterior movement of the tibia relative to the femur. As such, it is the knee ligament most often ruptured by athletes. While the ACL can be ruptured due to contact injuries, it is more often ruptured due to non-contact injuries, usually when an athlete hyperextends the knees or suddenly changes direction while moving.Current studies on ACL injuries have focused on trying to explain which sports place an athlete at greatest risk for ACL injuries, or why female athletes are more likely to suffer from ACL injuries than male athletes in a given sport. However, very little research has been conducted on how the incidences, or numbers of new cases per year, of ACL injuries compare among different countries. In this review, we look at studies on ACL injuries in the general populations of select countries, and in populations of athletes of specific sports in different countries, to see how their injury incidences compare.It is estimated that in the United States of America (USA), there are 200,000 ACL injuries, half of which require reconstructive surgeries. However, currently only Norway, Denmark, and Sweden have national web-based registries that accurately record nationwide ACL reconstructions, which are presumed to reflect the incidences of ACL injuries . Denmark is the only country to mandate reporting of ACL injuries to its registry [3]. Based on reviews of these registries since their first entries, the incidences of ACL injuries were 34 per 100,000 people in Norway, 38 per 100,000 people in Denmark, and 32 per 100,000 people in Sweden.Other studies using insurance claims for ACL reconstructions have found incidences of 32 per 100,000 people in Germany based on data from the 1990s show ACL incidences between 30 and 36 per 100,000 people, which is a similar range of incidences to those seen in the Scandinavian registries during the same period of time [5]. Overall, the data from these countries and the Scandinavian ones appear to show only a small variation in ACL injury incidences of entire national populations.Although national incidences of ACL injuries from these six countries appear to fall within a range of 29 to 38 per 100,000 people, studies of athletes playing the same sport in different countries have shown very different injury incidences. This is seen even as incidences are reported using different denominators; some studies report incidences as injuries per athlete per day, while others report them as injuries per athletic exposure. An athletic exposure is defined as one athlete participating in a single game or practice session that could expose him or her to injury [6]. Although many studies were prospective and therefore were able to AbstractAnterior cruciate ligament, or ACL, injuries are among the most common athletic injuries that occur in the world. While many studi...

Profile of Knee MRI Morphometric Risk Factors for Anterior Cruciate Ligament Tear at Dr. Soetomo General Academic Hospital

“…The NWI is a ratio of bicondylar width to notch width as measured on coronal PD sequence of MRI at the intersection level between Posterior Cruciate Ligament (PCL) and ACL or at the level of popliteal sulcus of lateral femoral condyle 3 . As shown in Figure 1.…”

“…Notch Width Index (NWI) is obtained from NW divided by BCW. 3 The Q-angle is an angle formed by the line that intersects the center of patellar bone and the center of tibial tuberosity in coronal projection with mediolateral longitudinal axis of femur. 3 As showed in Figure 2.…”

“…Anterior Cruciate Ligament (ACL) tear is one of the most common knee ligament abnormalities found in athletes, its incidence ranges from 29-38 per 100,000 people. [1][2][3] As a result, in the short term it might cause instability and in the long term it might cause degenerative process of knee joint. The most common type of ACL injury mechanism is non-contact type, due to pivoting movement, when the knee is slightly flexed and in valgus position then the femur undergoes external rotation as in foot maneuver movement during ball dribbling.…”

Is Pre-operative Quadriceps Strength a Predictive Factor for the Outcomes of Anterior Cruciate Ligament Reconstructions

“…Anterior cruciate ligament (ACL) injuries are the most commonly reported knee injuries in orthopaedics and sports medicine with about 300 000 anterior cruciate ligament reconstructions (ACLR) performed in USA annually [1,2]. ACLR is performed in order to restore normal knee stability in patients with ACL injury.…”

Knowledge and awareness toward anterior cruciate ligament (ACL) injury among population of Aseer region, Saudi Arabia

“…Also, it contributes to knee rotational stability in both frontal and transverse planes due to its specific orientation. [12]…”