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. 2013 Mar;45(3):462-9.
doi: 10.1249/MSS.0b013e318277acca.

Epidemiology of knee injuries among U.S. high school athletes, 2005/2006-2010/2011

David M Swenson  1 , Christy L Collins, Thomas M Best, David C Flanigan, Sarah K Fields, R Dawn Comstock
Affiliations

Epidemiology of knee injuries among U.S. high school athletes, 2005/2006-2010/2011

David M Swenson et al. Med Sci Sports Exerc. 2013 Mar.

Abstract

Purpose: U.S. high school athletes sustain millions of injuries annually. Detailed patterns of knee injuries, among the most costly sports injuries, remain largely unknown. We hypothesize that patterns of knee injuries in U.S. high school sports differ by sport and sex.

Methods: U.S. high school sports-related injury data were collected for 20 sports using the National High School Sports-Related Injury Surveillance System, High School RIO™. Knee injury rates, rate ratios (RR), and injury proportion ratios were calculated.

Results: From 2005/2006 to 2010/2011, 5116 knee injuries occurred during 17,172,376 athlete exposures (AE) for an overall rate of 2.98 knee injuries per 10,000 AE. Knee injuries were more common in competition than in practice (rate ratio = 3.53, 95% confidence interval [CI] = 3.34-3.73). Football had the highest knee injury rate (6.29 per 10,000 AE) followed by girls' soccer (4.53) and girls' gymnastics (4.23). Girls had significantly higher knee injury rates than boys in sex-comparable sports (soccer, volleyball, basketball, baseball/softball, lacrosse, swimming and diving, and track and field; RR = 1.52, 95% CI = 1.39-1.65). The most commonly involved structure was the medial collateral ligament (reported in 36.1% of knee injuries), followed by the patella/patellar tendon (29.5%), anterior cruciate ligament (25.4%), meniscus (23.0%), lateral collateral ligament (7.9%), and posterior cruciate ligament (2.4%). Girls were significantly more likely to sustain anterior cruciate ligament injuries in sex-comparable sports (RR = 2.38, 95% CI = 1.91-2.95). Overall, 21.2% of knee injuries were treated with surgery; girls were more often treated with surgery than boys in sex-comparable sports (injury proportion ratio = 1.30, 95% CI = 1.11-1.53).

Conclusions: Knee injury patterns differ by sport and sex. Continuing efforts to develop preventive interventions could reduce the burden of these injuries.

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Figures

FIGURE 1
FIGURE 1
Surgical treatment decisions for all knee injuries by sport High School Sports-Related Injury Surveillance Study, United States, 2005/06–2010/11.a a“Yes” or “no” were the only possible survey responses from 2005/06–2007/08. From 2008/09– 2010/11, possible responses were “No”, “Yes, injury was repaired with surgery prior to athlete’s return to play,” and “Yes, but athlete postponed surgery to continue to play.”
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