Abstract
PurposeIt is not known so far if ski-equipment-related factors differ between the ACL injury mechanisms, potentially influencing the circumstances and causes of falling, finally resulting in ACL injury. More specifically focusing on the injury mechanisms will provide a deeper understanding of injury causation. The aim of the study was to evaluate whether ACL injury mechanisms in recreational alpine skiing differ with regard to ski-geometric parameters, self-reported circumstances and causes of accident and injury severity.MethodsAmong a cohort of 392 ACL-injured (57.9% females) skiers, age, sex, height, weight, skill level, risk-taking behavior, circumstances and causes of accident, and ACL injury severity were collected by questionnaire. Additionally, patients had to recall their type of fall (ACL injury mechanism) by classifying forward and backward falls with and without body rotation. Ski length, side cut radius and widths of the tip, waist and tail were directly notated from the ski.ResultsThe forward fall with body rotation was the most common reported ACL injury mechanism (63%). A riskier behavior was associated with forward falls without body rotation. Ski-geometric parameters did not significantly influence the type of ACL injury mechanism. Regarding accident characteristics, catching an edge of the ski was more frequent (p < 0.001) the cause for forward falls (75% and 67%) when compared to the backward falls (46 and 15%) and executing a turn was the most frequent action in all falls (39–68%). A complete rupture of the ACL (66–70%) was more commonly reported than a partial tear (30–34%) among all four non-contact ACL injury mechanisms (n.s.).ConclusionIn contrast to risk-taking behavior and accident characteristics, ski-geometric parameters and injury severity do not significantly differ between ACL injury mechanisms in recreational skiing. Thus, an individual skiing style seems to have more impact on ACL injury mechanisms than ski equipment. Future studies should evaluate potential effects of ski geometry on the incidence of ACL injury.Level of evidenceIII.
Highlights
Recreational alpine skiing represents the most popular winter sport, annually enjoyed by several millions of people worldwide [5, 22]
According to Natri et al [12], four main non-contact anterior cruciate ligament (ACL) injury mechanisms in recreational skiing have been identified: (1) forward fall with body rotation (“valgus external rotation”), (2) backward fall with body rotation (“flexion internal rotation—phantom foot”) and (3) backward fall without body rotation “boot-induced anterior drawer” and (4) forward fall without body rotation
The forward fall with body rotation (63%) was the most common self-reported ACL injury mechanism, followed by the backward fall with body rotation (25%), forward fall without body rotation (9%) and backward fall without body rotation (3%)
Summary
Recreational alpine skiing represents the most popular winter sport, annually enjoyed by several millions of people worldwide [5, 22]. 3 medalp sportclinic, 6460 Imst, Austria number of skiers practicing this sport is associated with a certain risk for injury [7, 9]. Thousands of ski injuries are recorded each year, e.g., in Austria, despite the fact that the injury rate is even less than one injury per 1000 skier days [20]. The knee joint represents the most commonly affected anatomical location accounting for about one-third of all injuries among female and male skiers [3, 6, 20]. A study by Majewski et al [11] showed that almost 50% of knee-injured skiers ruptured their anterior cruciate ligament (ACL). Posch et al [15] demonstrated, that ACL ruptures with concomitant injuries, mostly to the medial collateral
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