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. 2018 Jun 13;6(6):2325967118777823.
doi: 10.1177/2325967118777823. eCollection 2018 Jun.

Epidemiology of Recurrent Anterior Cruciate Ligament Injuries in National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2004-2014

Itai Gans  1 , Julia S Retzky  2 , Lynne C Jones  1 , Miho J Tanaka  1
Affiliations

Epidemiology of Recurrent Anterior Cruciate Ligament Injuries in National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2004-2014

Itai Gans et al. Orthop J Sports Med. .

Abstract

Background: An anterior cruciate ligament (ACL) rupture is a serious injury that can be career-ending in collegiate athletics. A rerupture after primary ACL reconstruction occurs in 1% to 11% of all athletes.

Purpose: To describe the epidemiology of recurrent ACL ruptures in the 25 National Collegiate Athletic Association (NCAA) sports in the NCAA Injury Surveillance Program (ISP) and to identify and compare sport-specific risk factors for a recurrent ACL rupture.

Study design: Descriptive epidemiology study.

Methods: Athletes who experienced a primary or recurrent ACL rupture between 2004 and 2014 were identified using data from the NCAA ISP. ACL ruptures occurred in 12 of 25 sports during the study period. We assessed the rates and patterns of primary and recurrent ACL ruptures and reported them as events per 10,000 athlete-exposures (AEs). Sex-comparable sports were compared using rate ratios. Rupture rates were compared using odds ratios, with P values <.05 indicating significance. Regular-season and postseason data were combined because of low counts of postseason events.

Results: Of 350,416 AEs, there were 1105 ACL ruptures, 126 of which were recurrent. The highest rates of recurrent ACL ruptures (per 10,000 AEs) were among male football players (15), female gymnasts (8.2), and female soccer players (5.2). Of sports played by athletes of both sexes, women's soccer had a significantly higher rate of recurrent ACL ruptures than men's soccer (rate ratio, 3.8 [95% CI, 1.3-15]). Among all sports, men had a significantly higher rate of recurrent ACL ruptures (4.3) than women (3.0) (P = .04). Overall, the ratio of recurrent to primary ACL ruptures decreased over the 10-year study period. Both women and men had a decreasing trend of recurrent to primary ACL ruptures, although women had a steeper decrease.

Conclusion: These data can help identify athletes who are most at risk of recurrent ACL ruptures after ACL reconstruction and who may benefit from injury prevention programs.

Keywords: Injury Surveillance Program; National Collegiate Athletic Association; anterior cruciate ligament; primary rupture; recurrent rupture.

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Conflict of interest statement

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.

Figures

Figure 1.
Figure 1.
Ratio of recurrent to primary anterior cruciate ligament (ACL) tears by player sex.
See this image and copyright information in PMC

References

    1. Agel J, Rockwood T, Klossner D. Collegiate ACL injury rates across 15 sports: National Collegiate Athletic Association Injury Surveillance System data update (2004-2005 through 2012-2013). Clin J Sport Med. 2016;26(6):518–523. - PubMed
    1. Ahmed I, Salmon L, Roe J, Pinczewski L. The long-term clinical and radiological outcomes in patients who suffer recurrent injuries to the anterior cruciate ligament after reconstruction. Bone Joint J. 2017;99-B(3):337–343. - PubMed
    1. Allen MM, Pareek A, Krych AJ, et al. Are female soccer players at an increased risk of second anterior cruciate ligament injury compared with their athletic peers? Am J Sports Med. 2016;44(10):2492–2498. - PubMed
    1. Andernord D, Desai N, Bjornsson H, et al. Patient predictors of early revision surgery after anterior cruciate ligament reconstruction: a cohort study of 16,930 patients with 2-year follow-up. Am J Sports Med. 2015;43(1):121–127. - PubMed
    1. Bollen S. Epidemiology of knee injuries: diagnosis and triage. Br J Sports Med. 2000;34(3):227–228. - PMC - PubMed

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