Sport-Specific Yearly Risk and Incidence of Anterior Cruciate Ligament Tears in High School Athletes: A Systematic Review and Meta-Analysis

Gornitzky, Alex L.; Lott, Ariana; Yellin, Joseph L.; Fabricant, Peter D.; Ganley, Theodore J.

doi:10.1542/peds.140.1_meetingabstract.109

Cited by 67 publications

(93 citation statements)

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“…It is widely reported that certain anatomical features of the knee joint are associated with increased ACL‐injury risk in amateur and professional athletes . Of particular concern is the fact that adolescent females are 1.6 times more likely to suffer an ACL injury per athletic exposure compared with adolescent males . The morphological traits attributed to this disparity are a narrow intercondylar femoral notch, a narrow ACL, and a steep posterior tibial plateau .…”

Section: Discussionmentioning

confidence: 99%

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Schlecht

Martin

Ochocki

et al. 2019

Journal Orthopaedic Research

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Postnatal development and the physiological loading response of the anterior cruciate ligament (ACL) complex (ACL proper, entheses, and bony morphology) is not well understood. We tested whether the ACL-complex of two inbred mouse strains that collectively encompass the musculoskeletal variation observed in humans would demonstrate significant morphological differences following voluntary cage-wheel running during puberty compared with normal cage activity controls. Female A/J and C57BL/6J (B6) 6-week-old mice were provided unrestricted access to a standard cage-wheel for 4 weeks. A/J-exercise mice showed a 6.3% narrower ACL (p = 0.64), and a 20.1% more stenotic femoral notch (p < 0.01) while B6-exercise mice showed a 12.3% wider ACL (p = 0.10), compared with their respective controls. Additionally, A/J-exercise mice showed a 5.3% less steep posterior medial tibial slope (p = 0.07) and an 8.8% less steep posterior lateral tibial slope (p = 0.07), while B6-exercise mice showed a 9.8% more steep posterior medial tibial slope (p < 0.01) than their respective controls. A/J-exercise mice also showed more reinforcement of the ACL tibial enthesis with a 20.4% larger area (p < 0.01) of calcified fibrocartilage distributed at a 29.2% greater depth (p = 0.02) within the tibial enthesis, compared with their controls. These outcomes suggest exercise during puberty significantly influences ACL-complex morphology and that inherent morphological differences between these mice, as observed in their less active genetically similar control groups, resulted in a divergent phenotypic outcome between mouse strains.

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Section: Discussionmentioning

confidence: 99%

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Schlecht

Martin

Ochocki

et al. 2019

Journal Orthopaedic Research

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“…Anterior cruciate ligament (ACL) rupture is a common and preventable injury . Risk factors include young age and participation in ‘high‐risk’ sports . High‐risk sports include those involving contact or excessive acceleration, deceleration and pivoting motions, such as football, basketball, skiing, netball, lacrosse and rugby .…”

Section: Introductionmentioning

confidence: 99%

“…Risk factors include young age and participation in ‘high‐risk’ sports . High‐risk sports include those involving contact or excessive acceleration, deceleration and pivoting motions, such as football, basketball, skiing, netball, lacrosse and rugby . While males have a higher incidence of ACL injury, when adjusted for level of activity women have a greater risk of ACL injury per exposure .…”

Section: Introductionmentioning

confidence: 99%

Marked increase in the incidence of anterior cruciate ligament reconstructions in young females in New Zealand

Sutherland

Clatworthy

Fulcher³

et al. 2019

ANZ Journal of Surgery

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Background: Anterior cruciate ligament injuries cause significant morbidity, and may be increasing in incidence as participation in high-risk sports increases. The aim of this study is to investigate the incidence of anterior cruciate ligament reconstruction (ACLR) surgery in New Zealand, and to analyse changes over time in demographic subgroups. Method: Data were sourced from the Accident Compensation Corporation. Data relating to primary ACLRs performed from 2009 to 2016 were evaluated (n = 20 751). Baseline population estimates were obtained from national census data to calculate the incidence, and results were compared to previous data from 2000 to 2005 (n = 7375). Results: The annual incidence of ACLR for 2009-2016 was 58.2 per 100 000 person-years and was greater in males than in females (72.2 and 44.9, respectively). This represents a 58% increase when compared with the period 2000-2005 (36.9 per 100 000). The greatest increase was seen in females aged 15-19 years, with the incidence increasing by 120% in the last decade, compared with 53% in females aged 20-24 years. The percentage of injuries caused by sports changed from 65% over 2000-2005 to 76% over 2009-2016, with netball, rugby and football accounting for the highest number of injuries. Conclusion: The incidence of ACLR procedures has increased markedly in New Zealand, and this increase was most pronounced in females aged 15-19 years. A greater proportion of procedures are now due to sport-related injuries.

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“…The menisci redistribute contact forces, reducing tibiofemoral contact pressures, and aid in knee lubrication and nourishment. Injury to the anterior cruciate ligament (ACL) of the knee is common [1] and it has been estimated that up to 50% of ACL injuries include meniscal tearing [2]. In the medial meniscus, over 99% of these tears occur in the posterior region [3].…”

Section: 0 Introductionmentioning

confidence: 99%

Loading of the medial meniscus in the ACL deficient knee: A multibody computational study

Guess

Razu

2017

Medical Engineering & Physics

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The menisci of the knee reduce tibiofemoral contact pressures and aid in knee lubrication and nourishment. Meniscal injury occurs in half of knees sustaining anterior cruciate ligament injury and the vast majority of tears in the medial meniscus transpire in the posterior horn region. In this study, computational multibody models of the knee were derived from medical images and passive leg motion for two female subjects. The models were validated against experimental measures available in the literature and then used to evaluate medial meniscus contact force and internal hoop tension. The models predicted that the loss of anterior cruciate ligament (ACL) constraint increased contact and hoop forces in the medial menisci by a factor of 4 when a 100 N anterior tibial force was applied. Contact forces were concentrated in the posterior horn and hoop forces were also greater in this region. No differences were found in contact or hoop tension between the intact and ACL deficient (ACLd) knees when only a 5 Nm external tibial torque was applied about the long axis of the tibia. Combining a 100 N anterior tibial force and a 5 Nm external tibial torque increased posterior horn contact and hoop forces, even in the intact knee. The results of this study show that the posterior horn region of the medial meniscus experiences higher contact forces and hoop tension, making this region more susceptible to injury, especially with the loss of anterior tibia motion constraint provided by the ACL. The contribution of the dMCL in constraining posterior medial meniscus motion, at the cost of higher posterior horn hoop tension, is also demonstrated.

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Sport-Specific Yearly Risk and Incidence of Anterior Cruciate Ligament Tears in High School Athletes: A Systematic Review and Meta-Analysis

Cited by 67 publications

References 0 publications

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Marked increase in the incidence of anterior cruciate ligament reconstructions in young females in New Zealand

Loading of the medial meniscus in the ACL deficient knee: A multibody computational study

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