Between 2008 and 2022, Lower-Extremity Injuries Declined in Male Rugby Players, Whereas Noncontact Knee Injuries Showed No Decline in Female Rugby Players

Abstract

PurposeThe purpose of this study was to assess the distribution and mechanisms of lower extremity injuries among high school and college age rugby players presenting to United States (US) emergency departments (EDs) from 2008 to 2022. MethodsThe National Electronic Injury Surveillance System (NEISS) was queried for lower extremity rugby injuries (ages 14-23) from January 2008 to December 2022. Patient demographics, injury location, diagnosis, and disposition were extracted for each case. Linear regression analysis assessed differences over time. Injury distribution for males versus females was evaluated using Pearson’s chi-square analysis. ResultsAn estimated 31,318 (845 NEISS cases) high school and college-age rugby players presented to US EDs with a lower extremity injury during the study period. Males accounted for 66.9% of the injuries. Linear regression analysis revealed a significant decrease in annual frequency of lower extremity injuries presenting to US EDs from 2008 to 2022 (p=0.001). The most common injury mechanism was overwhelmingly a non-contact twisting motion (11,108, 35.5%) followed by a hit/collision (5,298, 16.9%). Strains/sprains were the most common diagnosis (17,243, 55.1%). Injuries most commonly occurred at the ankle (12,659, 40.4%) and knee (11,016, 35.2%). In a sex-specific linear regression analysis, there was a significant decrease in lower extremity injuries sustained by male players (p=0.001), but no significant decrease among female players (p=0.112). Furthermore, chi-squared analysis revealed that females sustained a significantly higher proportion of knee injuries secondary to twists (15.9% for females vs. 9.0% for males, p=0.01). ConclusionLower extremity injuries are declining among high school and college-age male rugby players. However, there has not been a corresponding decrease among female rugby players. Furthermore, females are disproportionately affected by non-contact twisting knee injuries.