Content area
Full text
Professor Emeritus Per Renström, Flötviksvägen 51, Hässelby, 16572 Sweden; [email protected]
The incidence of anterior cruciate ligament (ACL) injury remains high, especially in young athletes aged 14–19 years. In spite of the fact that some successful prevention programmes have been introduced, ACL injury continues to be the largest single problem in orthopaedic sports medicine, with the incidence of non-contact ACL tears being much higher in female athletes in sports such as basketball and team handball than in male athletes.
As ACL injury remains a significant problem, especially in young female athletes, procedures for improved prevention and management are needed. The mechanism of ACL injury is an important focus of discussion, as an ACL tear is more often a non-contact event with a deceleration or a change of direction manoeuvre than a contact or direct blow injury. A prophylactic neuromuscular and proprioceptive training programme may reduce the number of ACL injuries in female athletes.
The President of the International Olympic Committee (IOC) Jacques Rogge stated in 2001 that “the most important goal of the IOC Medical Commission is to protect the health of the athlete”. The IOC Medical Commission therefore invited a group of physicians, physical therapists, biomechanists and scientists active in ACL research to review current evidence relating to risk factors, prevention programmes and the need for further research concerning non-contact ACL injury in young female athletes.
EPIDEMIOLOGY OF ANTERIOR CRUCIATE LIGAMENT INJURIES
The incidence of ACL injuries in the sporting population has been estimated from a variety of sources including data on surgical reconstructions. Three national ACL surgical registries have been established (Norway 2004, Denmark 2005 and Sweden 2006)1 to gather information on the details of ACL surgery and to monitor the outcomes of this surgery. Information is gathered through a registration form completed by the surgeon postoperatively. From these registries we can estimate an incidence of ACL injury, although this number under-represents the true incidence as non-operative ACL injuries are not captured.
From the Norwegian data, a total of 2793 primary ACL ligament reconstruction operations were registered by 57 hospitals during 18 months. This corresponds to an annual population incidence of primary ACL reconstruction surgeries of 34 per 100 000 citizens (85 per 100 000 citizens in the main at-risk age group of...