Are Female Soccer Players at an Increased Risk of Second Anterior Cruciate Ligament Injury Compared with Their Athletic Peers?

Melissa M. Allen, Ayoosh Pareek, Aaron Krych, Timothy Hewett, Bruce A Levy, Michael J. Stuart, Diane L. Dahm

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Female soccer players have a well-known risk for anterior cruciate ligament (ACL) injury, but few studies have reported on second ACL injuries in this population. Purpose: To (1) report the rates of subsequent ACL injury (ipsilateral graft rupture or contralateral tear) in competitive female soccer players, (2) compare these rates with those of other female athletes of similar competitive level, (3) determine risk factors for second ACL injury, and (4) report clinical outcome scores in this population. Study Design: Cohort study; Level of evidence, 3. Methods: The medical records at a single institution were reviewed for female patients who were injured during a competitive athletic event and treated with primary ACL reconstruction (ACLR) between 1998 and 2013. Patients were followed for a mean of 68.8 months postoperatively (range, 24-115.2 months). Clinical outcome was obtained via Lysholm and International Knee Documentation Committee (IKDC) scores. Soccer players were matched 1:1 to non-soccer athletes for age, activity level, and graft type. Results: A total of 180 female ACLR patients with a mean ± SD age of 19.6 ± 6.9 years met the study inclusion and exclusion criteria (90 soccer players and 90 non-soccer players). Soccer players sustained more second ACL injuries, including both graft failures (11% vs 1%; P <.01) and contralateral ACL tears (17% vs 4%; P <.01), compared with non-soccer players. Of the 67 patients who returned to soccer after ACLR (mean age, 17.5 years; range, 13-27 years), significantly more had graft tears compared with those who did not return to soccer (15% vs 0%, respectively; P =.04); however, the difference in contralateral ACL tears (19% for returning players vs 9% for those who did not return; P =.34) was not significant. Relatively older age (odds ratio, 1.5 per year; P =.03) was a significant risk factor for ACL graft tear but not for contralateral ACL injury. Both groups had similar mean Lysholm (96 vs 95) and IKDC scores (95 vs 96) at final follow-up. Conclusion: Twenty-eight percent of all female soccer players and 34% of those players who returned to soccer had a second ACL tear. Soccer players had an increased rate of both graft tear and contralateral ACL injury compared with similar non-soccer athletes. Older age and return to soccer were significant risk factors for graft rupture.

Original languageEnglish (US)
Pages (from-to)2492-2498
Number of pages7
JournalAmerican Journal of Sports Medicine
Volume44
Issue number10
DOIs
StatePublished - Oct 1 2016

Fingerprint

Soccer
Sports
Transplants
Athletes
Documentation
Rupture
Knee
Anterior Cruciate Ligament Injuries
Anterior Cruciate Ligament Reconstruction
Tears
Population
Medical Records
Cohort Studies
Odds Ratio

Keywords

  • anterior cruciate ligament (ACL)
  • female athlete
  • football (soccer)
  • graft tear

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Are Female Soccer Players at an Increased Risk of Second Anterior Cruciate Ligament Injury Compared with Their Athletic Peers? / Allen, Melissa M.; Pareek, Ayoosh; Krych, Aaron; Hewett, Timothy; Levy, Bruce A; Stuart, Michael J.; Dahm, Diane L.

In: American Journal of Sports Medicine, Vol. 44, No. 10, 01.10.2016, p. 2492-2498.

Research output: Contribution to journalArticle

@article{d41b91048eb4462297ef12b7765b2125,
title = "Are Female Soccer Players at an Increased Risk of Second Anterior Cruciate Ligament Injury Compared with Their Athletic Peers?",
abstract = "Background: Female soccer players have a well-known risk for anterior cruciate ligament (ACL) injury, but few studies have reported on second ACL injuries in this population. Purpose: To (1) report the rates of subsequent ACL injury (ipsilateral graft rupture or contralateral tear) in competitive female soccer players, (2) compare these rates with those of other female athletes of similar competitive level, (3) determine risk factors for second ACL injury, and (4) report clinical outcome scores in this population. Study Design: Cohort study; Level of evidence, 3. Methods: The medical records at a single institution were reviewed for female patients who were injured during a competitive athletic event and treated with primary ACL reconstruction (ACLR) between 1998 and 2013. Patients were followed for a mean of 68.8 months postoperatively (range, 24-115.2 months). Clinical outcome was obtained via Lysholm and International Knee Documentation Committee (IKDC) scores. Soccer players were matched 1:1 to non-soccer athletes for age, activity level, and graft type. Results: A total of 180 female ACLR patients with a mean ± SD age of 19.6 ± 6.9 years met the study inclusion and exclusion criteria (90 soccer players and 90 non-soccer players). Soccer players sustained more second ACL injuries, including both graft failures (11{\%} vs 1{\%}; P <.01) and contralateral ACL tears (17{\%} vs 4{\%}; P <.01), compared with non-soccer players. Of the 67 patients who returned to soccer after ACLR (mean age, 17.5 years; range, 13-27 years), significantly more had graft tears compared with those who did not return to soccer (15{\%} vs 0{\%}, respectively; P =.04); however, the difference in contralateral ACL tears (19{\%} for returning players vs 9{\%} for those who did not return; P =.34) was not significant. Relatively older age (odds ratio, 1.5 per year; P =.03) was a significant risk factor for ACL graft tear but not for contralateral ACL injury. Both groups had similar mean Lysholm (96 vs 95) and IKDC scores (95 vs 96) at final follow-up. Conclusion: Twenty-eight percent of all female soccer players and 34{\%} of those players who returned to soccer had a second ACL tear. Soccer players had an increased rate of both graft tear and contralateral ACL injury compared with similar non-soccer athletes. Older age and return to soccer were significant risk factors for graft rupture.",
keywords = "anterior cruciate ligament (ACL), female athlete, football (soccer), graft tear",
author = "Allen, {Melissa M.} and Ayoosh Pareek and Aaron Krych and Timothy Hewett and Levy, {Bruce A} and Stuart, {Michael J.} and Dahm, {Diane L.}",
year = "2016",
month = "10",
day = "1",
doi = "10.1177/0363546516648439",
language = "English (US)",
volume = "44",
pages = "2492--2498",
journal = "American Journal of Sports Medicine",
issn = "0363-5465",
publisher = "SAGE Publications Inc.",
number = "10",

}

TY - JOUR

T1 - Are Female Soccer Players at an Increased Risk of Second Anterior Cruciate Ligament Injury Compared with Their Athletic Peers?

AU - Allen, Melissa M.

AU - Pareek, Ayoosh

AU - Krych, Aaron

AU - Hewett, Timothy

AU - Levy, Bruce A

AU - Stuart, Michael J.

AU - Dahm, Diane L.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Background: Female soccer players have a well-known risk for anterior cruciate ligament (ACL) injury, but few studies have reported on second ACL injuries in this population. Purpose: To (1) report the rates of subsequent ACL injury (ipsilateral graft rupture or contralateral tear) in competitive female soccer players, (2) compare these rates with those of other female athletes of similar competitive level, (3) determine risk factors for second ACL injury, and (4) report clinical outcome scores in this population. Study Design: Cohort study; Level of evidence, 3. Methods: The medical records at a single institution were reviewed for female patients who were injured during a competitive athletic event and treated with primary ACL reconstruction (ACLR) between 1998 and 2013. Patients were followed for a mean of 68.8 months postoperatively (range, 24-115.2 months). Clinical outcome was obtained via Lysholm and International Knee Documentation Committee (IKDC) scores. Soccer players were matched 1:1 to non-soccer athletes for age, activity level, and graft type. Results: A total of 180 female ACLR patients with a mean ± SD age of 19.6 ± 6.9 years met the study inclusion and exclusion criteria (90 soccer players and 90 non-soccer players). Soccer players sustained more second ACL injuries, including both graft failures (11% vs 1%; P <.01) and contralateral ACL tears (17% vs 4%; P <.01), compared with non-soccer players. Of the 67 patients who returned to soccer after ACLR (mean age, 17.5 years; range, 13-27 years), significantly more had graft tears compared with those who did not return to soccer (15% vs 0%, respectively; P =.04); however, the difference in contralateral ACL tears (19% for returning players vs 9% for those who did not return; P =.34) was not significant. Relatively older age (odds ratio, 1.5 per year; P =.03) was a significant risk factor for ACL graft tear but not for contralateral ACL injury. Both groups had similar mean Lysholm (96 vs 95) and IKDC scores (95 vs 96) at final follow-up. Conclusion: Twenty-eight percent of all female soccer players and 34% of those players who returned to soccer had a second ACL tear. Soccer players had an increased rate of both graft tear and contralateral ACL injury compared with similar non-soccer athletes. Older age and return to soccer were significant risk factors for graft rupture.

AB - Background: Female soccer players have a well-known risk for anterior cruciate ligament (ACL) injury, but few studies have reported on second ACL injuries in this population. Purpose: To (1) report the rates of subsequent ACL injury (ipsilateral graft rupture or contralateral tear) in competitive female soccer players, (2) compare these rates with those of other female athletes of similar competitive level, (3) determine risk factors for second ACL injury, and (4) report clinical outcome scores in this population. Study Design: Cohort study; Level of evidence, 3. Methods: The medical records at a single institution were reviewed for female patients who were injured during a competitive athletic event and treated with primary ACL reconstruction (ACLR) between 1998 and 2013. Patients were followed for a mean of 68.8 months postoperatively (range, 24-115.2 months). Clinical outcome was obtained via Lysholm and International Knee Documentation Committee (IKDC) scores. Soccer players were matched 1:1 to non-soccer athletes for age, activity level, and graft type. Results: A total of 180 female ACLR patients with a mean ± SD age of 19.6 ± 6.9 years met the study inclusion and exclusion criteria (90 soccer players and 90 non-soccer players). Soccer players sustained more second ACL injuries, including both graft failures (11% vs 1%; P <.01) and contralateral ACL tears (17% vs 4%; P <.01), compared with non-soccer players. Of the 67 patients who returned to soccer after ACLR (mean age, 17.5 years; range, 13-27 years), significantly more had graft tears compared with those who did not return to soccer (15% vs 0%, respectively; P =.04); however, the difference in contralateral ACL tears (19% for returning players vs 9% for those who did not return; P =.34) was not significant. Relatively older age (odds ratio, 1.5 per year; P =.03) was a significant risk factor for ACL graft tear but not for contralateral ACL injury. Both groups had similar mean Lysholm (96 vs 95) and IKDC scores (95 vs 96) at final follow-up. Conclusion: Twenty-eight percent of all female soccer players and 34% of those players who returned to soccer had a second ACL tear. Soccer players had an increased rate of both graft tear and contralateral ACL injury compared with similar non-soccer athletes. Older age and return to soccer were significant risk factors for graft rupture.

KW - anterior cruciate ligament (ACL)

KW - female athlete

KW - football (soccer)

KW - graft tear

UR - http://www.scopus.com/inward/record.url?scp=84989827128&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84989827128&partnerID=8YFLogxK

U2 - 10.1177/0363546516648439

DO - 10.1177/0363546516648439

M3 - Article

C2 - 27261476

AN - SCOPUS:84989827128

VL - 44

SP - 2492

EP - 2498

JO - American Journal of Sports Medicine

JF - American Journal of Sports Medicine

SN - 0363-5465

IS - 10

ER -