Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005-2015.

Caroline Finch,Louise Shaw

doi:10.3390/ijerph14060599

Abstract

Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015. There was a total of 320 cases and the overall annual rate of ACL injuries increased by 147.8% from 2.74 per 100,000 population in 2005/2006 to 6.79 per 100,000 in 2014/2015. The majority (96.9%) of these injuries were in 10- to 14-year-olds. The main in-hospital procedure provided to over 80% of the hospitalized cases involved ACL reconstruction. Sporting activities accounted for 56.6% of ACL injuries. For females, over half (52.4%) of ACL injuries occurred whilst playing ball sports, compared to 35.4% of males. The large increase in ACL injuries in 5- to 14-year-olds in the state of Victoria, Australia over a 10-year period indicates they are a significant and emerging health burden. Population-wide ACL prevention policies are required to halt these trends. Cost effective prevention programs that involve neuromuscular training must be implemented in schools and junior sports teams.

Highlights

Children and adolescent participation in organized sports is widespread and gaining in popularity in Western countries [1], with children often beginning participation at a younger age and competing at a higher level [2]
The incidence of hospital-treated Anterior Cruciate Ligament (ACL) injuries in people aged 5 to 14 years increased by 147.8% in Victoria, Australia between July 2005 and June 2015
This paper provides new data that show a somewhat alarming increasing trend in ACL injury rates in children and adolescents over time

Summary

Introduction

Children and adolescent participation in organized sports is widespread and gaining in popularity in Western countries [1], with children often beginning participation at a younger age and competing at a higher level [2]. Greater demands are being placed on youth athletes, through increased training, sports specialization, and an emphasis on year-round competitive play [2]. Anterior Cruciate Ligament (ACL) injury to the knee, in children and adolescents, has been the focus of recent media and scholarly attention in Australia [4,5]. This is not surprising given that ACL injury causes significant discomfort and disability and may result in the long-term in reduced levels of physical activity and contribute to obesity [6], negating the potential benefits of sports participation for children and adolescents. ACL injuries have the potential for adverse long-term health outcomes, such as an increased risk of degenerative arthritis and escalation of health care costs [1,7,8]

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