ACL Tears in School-Aged Children and Adolescents Over 20 Years
ACL Tears in School-Aged Children and Adolescents Over 20 Years
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DOI：
10.1542/peds.2016-1877
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发表时间：
2017-03-01
期刊：
影响因子：
8
通讯作者：
Tompkins, Marc
中科院分区：
文献类型：
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作者：
Beck, Nicholas A.;Lawrence, J. Todd R.;Tompkins, Marc
背景：前十字韧带(ACL)撕裂被认为在年轻患者中发生的频率越来越高。没有研究表明，随着时间的推移，发病率会增加。我们假设年轻患者前交叉韧带撕裂的发生率在过去20年中有所增加。方法：这项描述性流行病学研究回顾了1994-2013年间所有6-18岁患者的保险账单数据，使用的是当前程序术语、前交叉韧带撕裂和重建的第四修订代码或国际疾病分类、第九修订、临床修改代码。根据年龄和性别，对保险数据库中每年登记的人员的伤害情况进行了标准化。根据性别和年龄(6-14岁、15-16岁和17-18岁)进行分析。结果：前交叉韧带撕裂率每10万人年平均121+/-19(范围92-151)。除男性6至14岁和17至18岁年龄组外，所有趋势均显著增加。总体而言，年增长率为2.3%。除17至18岁年龄段外，女性发病率明显较高。女性在16岁达到高峰，男性在17岁达到高峰，前交叉韧带撕裂率分别为392/10万人年和422/10万人年。除17至18岁组外，女性风险较高。高中生的发病率最高。这些数据有助于针对ACL预防计划中风险最高的患者。
BACKGROUND: Anterior cruciate ligament (ACL) tears are thought to occur with increasing abstract frequency in young patients. No study has shown increased incidence over time. We hypothesized the incidence of ACL tears in young patients has increased over the past 20 years.METHODS: This descriptive epidemiology study is a retrospective review of insurance billing data of all patients aged 6 to 18 years with Current Procedural Terminology, Fourth Revision codes for ACL tear and reconstruction or International Classification of Diseases, Ninth Revision, Clinical Modification codes from 1994 to 2013. Injuries were normalized to persons per year enrolled in the insurance database based on age and sex. Analysis was performed based on sex and age (6-14, 15-16, and 17-18 years).RESULTS: The rate of ACL tears per 100 000 person-years averaged 121 +/- 19 (range 92-151). All trends increased significantly except for the male 6-to 14-year-old and 17-to 18-yearold age groups. Overall there was an annual increase of 2.3%. Females had significantly higher incidence except in the 17-to 18-year-olds. Females peaked at age 16 years and males at age 17 years, with rates of 392 ACL tears and 422 ACL tears per 100 000 personyears, respectively.CONCLUSIONS: The incidence of ACL tears in pediatric patients increased over the last 20 years. Females were at higher risk except in the 17-to 18-year-old group. Peak incidence is noted during high school years. These data help target the most at-risk patients for ACL prevention programs.