Marianne Bakke Johnsen1,2, Maren Hjelle Guddal3,2, Milada Cvancarova Småstuen3,4, Håvard Moksnes5, Lars Engebretsen2,5,6, Kjersti Storheim3,2, John-Anker Zwart3,2. 1. Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway m.b.johnsen@medisin.uio.no. 2. Faculty of Medicine, University of Oslo, Oslo, Norway. 3. Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway. 4. Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway. 5. Oslo Sport Trauma Research Center, Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway. 6. Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Abstract
BACKGROUND: An anterior cruciate ligament (ACL) injury is a severe injury that may require ACL reconstruction (ACLR) to enable the return to sport. Risk factors for ACLR have not firmly been established in the general adolescent population. PURPOSE: To investigate the incidence and risk factors for ACLR in a population-based cohort of adolescents. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We prospectively followed 7644 adolescents from the adolescent part of the Nord-Trøndelag Health Study, included from 2006 to 2008. The main risk factors of interest were the level of sport participation (level I, II, or III) and sport competitions. The endpoint was primary ACLR recorded in the Norwegian National Knee Ligament Registry between January 2006 and December 2013. RESULTS: A total of 3808 boys and 3836 girls were included in the analyses. We identified 69 (0.9%) ACLRs with a median of 7.3 years of follow-up, providing an overall ACLR incidence of 38.9 (95% CI, 30.7-49.3) per 100,000 person-years. The hazard ratio (HR) for ACLR associated with level I sport participation was 3.93 (95% CI, 0.92-16.80) for boys and 3.31 (95% CI, 1.30-8.43) for girls. There was a stronger association related to participating in sport competitions. Girls had over 5 times a higher risk (HR, 5.42; 95% CI, 2.51-11.70) and boys over 4 times the risk (HR, 4.22; 95% CI, 1.58-11.30) of ACLR compared with those who did not compete. CONCLUSION: Participating in level I sports and sport competitions significantly increased the risk of undergoing primary ACLR. Preventive strategies should be implemented to reduce the incidence and future burden of ACLR.
BACKGROUND: An anterior cruciate ligament (ACL) injury is a severe injury that may require ACL reconstruction (ACLR) to enable the return to sport. Risk factors for ACLR have not firmly been established in the general adolescent population. PURPOSE: To investigate the incidence and risk factors for ACLR in a population-based cohort of adolescents. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We prospectively followed 7644 adolescents from the adolescent part of the Nord-Trøndelag Health Study, included from 2006 to 2008. The main risk factors of interest were the level of sport participation (level I, II, or III) and sport competitions. The endpoint was primary ACLR recorded in the Norwegian National Knee Ligament Registry between January 2006 and December 2013. RESULTS: A total of 3808 boys and 3836 girls were included in the analyses. We identified 69 (0.9%) ACLRs with a median of 7.3 years of follow-up, providing an overall ACLR incidence of 38.9 (95% CI, 30.7-49.3) per 100,000 person-years. The hazard ratio (HR) for ACLR associated with level I sport participation was 3.93 (95% CI, 0.92-16.80) for boys and 3.31 (95% CI, 1.30-8.43) for girls. There was a stronger association related to participating in sport competitions. Girls had over 5 times a higher risk (HR, 5.42; 95% CI, 2.51-11.70) and boys over 4 times the risk (HR, 4.22; 95% CI, 1.58-11.30) of ACLR compared with those who did not compete. CONCLUSION: Participating in level I sports and sport competitions significantly increased the risk of undergoing primary ACLR. Preventive strategies should be implemented to reduce the incidence and future burden of ACLR.
Authors: Alicia M Montalvo; Daniel K Schneider; Laura Yut; Kate E Webster; Bruce Beynnon; Mininder S Kocher; Gregory D Myer Journal: Br J Sports Med Date: 2018-03-07 Impact factor: 13.800
Authors: Eric Hamrin Senorski; Romain Seil; Eleonor Svantesson; Julian A Feller; Kate E Webster; Lars Engebretsen; Kurt Spindler; Rainer Siebold; Jón Karlsson; Kristian Samuelsson Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-11-29 Impact factor: 4.342
Authors: F Accadbled; G Gracia; P Laumonerie; C Thevenin-Lemoine; B E Heyworth; M S Kocher Journal: J Child Orthop Date: 2019-10-01 Impact factor: 1.548