Epidemiology of meniscal injuries in US high school athletes between 2007 and 2013

Abstract

Purpose: Knowledge of epidemiologic trends of meniscal injuries in young active populations is limited. Better awareness of injury patterns is a first step to lowering injury rates. Our hypothesis was that meniscal injuries in high school athletes would vary by gender, sport, and type of exposure.

Methods: During the 2007/2008 and 2012/2013 academic years, a large nationally disperse sample of US high schools reported athlete exposure and injury data for 22 sports by having certified athletic trainers complete an internet-based data collection tool.

Results: One thousand and eighty-two meniscal injuries were reported during 21,088,365 athlete exposures for an overall injury rate of 5.1 per 100,000 athlete exposures. The overall rate of injury was higher in competition (11.9) than practice (2.7) (RR = 4.4; 95% CI 3.9-5.0), and 12/19 sports showed significantly higher injury rates in competition compared to practice. Of all injuries, 68.0% occurred in boys, yet among the gender-comparable sports of soccer, basketball, track and field, lacrosse, and baseball/softball injury rates were higher for girls than boys (5.5 and 2.5, respectively, RR = 2.2; 95% CI 1.8-2.7). Contact injury represented the most common mechanism (55.9%). Surgery was performed for the majority of injuries (63.8%), and 54.0% of athletes had associated intra-articular knee pathology.

Conclusions: Meniscal injury patterns among high school athletes vary by gender, sport, and type of exposure. Our study is clinically relevant because recognition of distinct differences in these injury patterns will help drive evidence-based, targeted injury prevention strategies and efforts.

Level of evidence: III.

Keywords: Gender; High school athletes; Mechanism of injury; Meniscus.

Figure 1

Meniscal Injuries as a Proportion of All Knee Injuries, National High School Sports-Related Injury Surveillance Study, United States, 2007/08 – 2012/13. * Buys’ swimming and diving, Boys’ volleyball, and Girls’ cheerleading reported no meniscal injuries during the study period and were therefore excluded from this analysis.

Figure 2

Proportion of Meniscal Injuries Requiring Surgery by Sport, National High School Sports-Related Injury Surveillance Study, United States, 2007/08 – 2012/13. * Boys’ swimming and diving, Boys’ volleyball, and Boys’ cross country reported no meniscal injuries during the study period and where therefore excluded, as was Girls’ cross county meniscal injury due to missing surgery data for the only meniscal injury.