A team of researchers from the University of Oslo has observed a significantly increased risk of undergoing primary ACL reconstruction among adolescents who participate in level I sports and sport competitions.
“Even though we are well-aware of the health benefits of engaging in physical activity for children and adolescents, we should be aware of the high risk of musculoskeletal injuries, especially in level I sports (soccer, handball),” says Marianne Brakke Johnsen, MSc, of the Communication and Research Unit for Musculoskeletal Disorders at Oslo University Hospital and faculty of medicine at the University of Oslo, in Norway, according to a media release from Healio.
In their study, published recently in the American Journal of Sports Medicine, Johnsen and her colleagues prospectively followed 7,644 adolescents (3,808 boys and 3,836 girls) who were included in the Young-Nord-Trøndelag Health Study from 2006 to 2008. Level of sport participation and sport competitions were included as main risk factors of interest, and the endpoint was primary ACL reconstruction recorded in the Norwegian National Knee Ligament Registry between January 2006 and December 2013.
Results showed an overall incidence of 38.9 per 100,000 person-years, with 69 ACL reconstructions identified with a median follow-up of 7.3 years. Researchers noted level I sports had an ACL reconstruction incidence rate over 3 times higher than level II or level III sports, which was also seen in sex-stratified and age-adjusted analyses. However, the increased risk of ACL reconstruction associated with level I sports was only statistically significant for girls.
Compared with adolescents who did not compete in sports, the patients who participated in sport competitions had a 4-times higher incidence of ACL reconstruction. Adjusted analyses showed there was a statistically significant increase in risk of ACL reconstruction in girls and boys, the release explains.
“The findings were not surprising, as high risk of ACL injury and ACL reconstruction have been associated with level I sports in previous studies and the difference in incidence of ACL reconstruction between boys and girls,” Johnsen shares. “However, we were a little surprised the findings were also clear in a population-based cohort of adolescents, as previous studies predominantly have been performed on athlete populations.”
According to Johnsen, it is important that injury prevention programs be prioritized among adolescents to reduce the risk of ACL injury and ACL reconstruction. Beyond that, coaches, parents, and team leaders should be informed about the risk factors for injury so they are aware of what to look for in adolescent athletes, the release adds.
“The injury prevention training can be part of the warm-up routine and can, in addition to preventing injury, be beneficial for performance in general,” Johnsen states.