The Effects of Level of Competition, Sport, and Sex on the Incidence of First-Time Noncontact Anterior Cruciate Ligament Injury
The Effects of Level of Competition, Sport, and Sex on the Incidence of First-Time Noncontact Anterior Cruciate Ligament Injury
复制标题
DOI：
10.1177/0363546514540862
复制
发表时间：
2014-08-01
影响因子：
4.8
通讯作者：
Johnson, Robert J.
中科院分区：
文献类型：
--
作者：
Beynnon, Bruce D.;Vacek, Pamela M.;Johnson, Robert J.
背景：前交叉韧带（ACL）损伤是致残的，并且与创伤后骨关节炎的早期发病有关。关于体育赛事中首次非接触性前交叉韧带损伤的发生率，以及它们如何受到比赛水平、运动类型和参与者性别的独立影响，我们知之甚少。假设：比赛水平（大学或高中）、运动类型（足球、篮球、长曲棍球、曲棍球、足球、橄榄球、排球）和运动员的性别独立影响首次非接触性ACL损伤的发生率。研究设计：队列研究；证据等级2。方法：2008年秋季至2012年春季，收集来自8所大学和18所高中7个体育项目的首次非接触性ACL损伤数据。运动员的暴露是通过球队名单和计划的训练和比赛的数量来回顾性计算的。损伤发生率（IRs）计算每1000名运动员暴露。比赛水平、运动和性别对前交叉韧带损伤风险的独立影响通过泊松回归估计。结果：在所有研究的运动项目中，大学报告了48例ACL损伤，320,719名运动员暴露（IR = 0.150 / 1000人日），而高中报告了53例损伤，873,057名运动员暴露（IR = 0.061）。在调整运动和性别差异后，大学运动员的受伤风险明显高于高中运动员（调整后的相对风险[RR]， 2.38; 95% CI, 1.55-3.54）。女性运动员的总体IR为0.112，而男性运动员为0.063。在调整运动和比赛水平后，女性首次ACL损伤的可能性是男性的两倍多（RR, 2.10; 95% CI, 1.34-3.27）。以长曲棍球为参照组，与比赛水平和性别无关，足球运动员（RR, 1.77）和橄榄球运动员（RR, 2.23）的首次非接触性前交叉韧带损伤风险显著高于足球运动员（RR, 1.77）。结论：运动员发生首次非接触性前交叉韧带损伤的风险独立地受比赛水平、参与者的性别和运动类型的影响，它们之间的影响没有相互作用。在所研究的人群中，女大学生运动员发生首次非接触性前交叉韧带损伤的风险最高。
Background: Anterior cruciate ligament (ACL) injuries are disabling and are associated with the early onset of posttraumatic osteoarthritis. Little is known regarding the incidence rate of first-time noncontact ACL injuries sustained during athletic events and how they are independently influenced by level of competition, type of sport, and the participant's sex.Hypothesis: Level of competition (college or high school), type of sport (soccer, basketball, lacrosse, field hockey, football, rugby, volleyball), and the athlete's sex independently influence the incidence rate of first-time noncontact ACL injuries.Study Design: Cohort study; Level of evidence, 2.Methods: Between fall 2008 and spring 2012, first-time noncontact ACL injury data were collected from 8 colleges and 18 high schools across 7 sports. Athlete exposure was computed retrospectively using team rosters and numbers of scheduled practices and games. Injury incidence rates (IRs) were computed per 1000 athlete exposures. The independent effects of level of competition, sport, and sex on ACL injury risk were estimated by Poisson regression.Results: Colleges reported 48 ACL injuries with 320,719 athlete exposures across all sports studied (IR = 0.150 per 1000 person-days), while high schools reported 53 injuries with 873,057 athlete exposures (IR = 0.061). After adjustment for differences in sport and sex, college athletes had a significantly higher injury risk than did high school athletes (adjusted relative risk [RR], 2.38; 95% CI, 1.55-3.54). The overall IR for female athletes was 0.112 compared with 0.063 for males. After adjustment for sport and level of play, females were more than twice as likely to have a first-time ACL injury compared with males (RR, 2.10; 95% CI, 1.34-3.27). With lacrosse as the reference group, risk of first-time noncontact ACL injury was significantly higher for soccer players (RR, 1.77) and for rugby players (RR, 2.23), independent of level of play and sex.Conclusion: An athlete's risk of having a first-time noncontact ACL injury is independently influenced by level of competition, the participant's sex, and type of sport, and there are no interactions between their effects. Female college athletes have the highest risk of having a first-time noncontact ACL injury among the groups studied.