Comparison Of Risk Factors For Females Sustaining Acl Injuries Versus Ankle Sprains

Abstract

BACKGROUND: Ankle sprain and anterior cruciate ligament (ACL) injury are common lower extremity injuries among athletes. Ankle sprain is the most common athletic injury and accounts for approximately half of all injuries. ACL injury, although more rare, may occur due to similar mechanisms and often incurs longer rehabilitation and abstinence from sport. Although females experience greater rates of ACL injury than do males, they experience the same amount of ankle sprains. Little is known as to why this difference exists or what risk factors may be unique to each. PURPOSE: To asses risk factors among females sustaining ankle sprain versus ACL injuries. METHODS: All cases of ACL reconstruction and ankle sprain in females ages 15-39 years from 2002-2012 were gathered from Clinformatics Data Mart database and matched to non-injured controls at a 1:3 ratio by age, region, and index date. Conditional logistic regression was used to calculate the adjusted odds ratios (aORs) and 95% CIs for the risk of each outcome with a range of sociodemographic and clinical predictor variables. Association of risk factors were examined and compared between the two models. Variables of interest included history of lower extremity injury, oral contraceptive use, antibiotic use, corticosteroid use, and aggregate comorbidity (Elixhauser). RESULTS: 12,819 cases of ACL reconstruction and 134,299 cases of ankle sprain were included in this study. Those sustaining ankle sprains were more likely to have sustained previous lower extremity injury compared to those receiving ACL reconstruction, aOR of 4.08 vs. 2.76, respectively. Those sustaining ankle sprains also had higher odds of comorbidity than the ACL cohort. Among ACL injuries, injectable corticosteroid use was more common, aOR of 2.08 vs 1.41. CONCLUSIONS: Ankle sprain and ACL injury appear to have different risk factors. In general, we found that those with ACL injuries were more likely to have received corticosteroid injections and less likely to have had a previous lower extremity injury or comorbid condition compared to those with ankle sprains. Monitoring of higher risk individuals by coaches and athletic trainers may be beneficial in preventing these injuries. Further, these risk factors may help identify injured individuals requiring extended rehabilitation and/or rest from sport.