Incidence of Knee Injuries on Artificial Turf Versus Natural Grass in National Collegiate Athletic Association American Football: 2004-2005 Through 2013-2014 Seasons

2019 ◽  
Vol 47 (6) ◽  
pp. 1294-1301 ◽  
Author(s):  
Galvin J. Loughran ◽  
Christian T. Vulpis ◽  
Jordan P. Murphy ◽  
David A. Weiner ◽  
Steven J. Svoboda ◽  
...  
Keyword(s):  
National Collegiate Athletic Association ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
American Football ◽  
Artificial Turf ◽  
Acl Injuries ◽  
Injury Rates ◽  
Knee Ligament ◽  
Natural Grass ◽  
Competition Level

Background: The use of artificial turf in American football continues to grow in popularity, and the effect of these playing surfaces on athletic injuries remains controversial. Knee injuries account for a significant portion of injuries in the National Collegiate Athletic Association (NCAA) football league; however, the effect of artificial surfaces on knee injuries remains ill-defined. Hypothesis: There is no difference in the rate or mechanism of knee ligament and meniscal injuries during NCAA football events on natural grass and artificial turf playing surfaces. Study Design: Descriptive epidemiology study. Methods: The NCAA Injury Surveillance System Men’s Football Injury and Exposure Data Sets for the 2004-2005 through 2013-2014 seasons were analyzed to determine the incidence of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), medial meniscus, and lateral meniscal tear injuries. Injury rates were calculated per 10,000 athlete exposures, and rate ratios (RRs) were used to compare injury rates during practices and competitions on natural grass and artificial turf in NCAA football as a whole and by competition level (Divisions I, Divisions II and III). Mechanisms of injury were calculated for each injury on natural grass and artificial turf surfaces. Results: A total of 3,009,205 athlete exposures and 2460 knee injuries were reported from 2004 to 2014: 1389 MCL, 522 ACL, 269 lateral meniscal, 164 medial meniscal, and 116 PCL. Athletes experienced all knee injuries at a significantly higher rate when participating in competitions as compared with practices. Athletes participating in competitions on artificial turf experienced PCL injuries at 2.94 times the rate as those playing on grass (RR = 2.94; 95% CI, 1.61-5.68). When stratified by competition level, Division I athletes participating in competitions on artificial turf experienced PCL injuries at 2.99 times the rate as those playing on grass (RR = 2.99; 95% CI, 1.39-6.99), and athletes in lower NCAA divisions (II and III) experienced ACL injuries at 1.63 times the rate (RR = 1.63; 95% CI, 1.10-2.45) and PCL injuries at 3.13 times the rate (RR = 3.13; 95% CI, 1.14-10.69) on artificial turf as compared with grass. There was no statistically significant difference in the rate of MCL, medial meniscal, or lateral meniscal injuries on artificial turf versus grass when stratified by event type or level of NCAA competition. No difference was found in the mechanisms of knee injuries on natural grass and artificial turf. Conclusion: Artificial turf is an important risk factor for specific knee ligament injuries in NCAA football. Injury rates for PCL tears were significantly increased during competitions played on artificial turf as compared with natural grass. Lower NCAA divisions (II and III) also showed higher rates of ACL injuries during competitions on artificial turf versus natural grass.

scholarly journals Epidemiology of Anterior Cruciate Ligament Injury on Natural Grass Versus Artificial Turf in Soccer: 10-Year Data From the National Collegiate Athletic Association Injury Surveillance System

2020 ◽  
Vol 8 (7) ◽  
pp. 232596712093443
Author(s):  
Mark Howard ◽  
Samantha Solaru ◽  
Hyunwoo P. Kang ◽  
Ioanna K. Bolia ◽  
George F.R. Hatch ◽  
...  
Keyword(s):  
National Collegiate Athletic Association ◽  
Cruciate Ligament ◽  
Injury Rate ◽  
Acl Injury ◽  
Soccer Players ◽  
Artificial Turf ◽  
Injury Surveillance System ◽  
Injury Rates ◽  
Natural Grass ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injury is prevalent among National Collegiate Athletic Association (NCAA) soccer players. Controversy remains regarding the effect of the surface type on the rate of ACL injury in soccer players, considering differences in sex, type of athletic exposure, and level of competition. Hypothesis: Natural grass surfaces would be associated with decreased ACL injury rate in NCAA soccer players. Sex, type of athletic exposure (match vs practice), and level of competition (Division I-III) would affect the relationship between playing surface and ACL injury rates. Study Design: Cohort study; Level of evidence, 3. Methods: Using the NCAA Injury Surveillance System (ISS) database, we calculated the incidence rate of ACL injury in men and women from 2004-2005 through 2013-2014 seasons. The incidence was normalized against athletic exposure (AE). Additional data collected were sex, athletic activity at time of injury (match vs practice), and level of competition (NCAA division) to stratify the analysis. Statistical comparisons were made by calculating incidence rate ratios (IRR). Statistical significance was set at an alpha of .05. Results: There were 30,831,779 weighted AEs during the study period. The overall injury rate was 1.12 ACL injuries per 10,000 AEs (95% CI, 1.08-1.16). Women comprised 57% of the match data (10,261 games) and 55% of practice data (26,664 practices). The overall injury rate was significantly higher on natural grass (1.16/10,000 AEs; 95% CI, 1.12-1.20) compared with artificial turf (0.92/10,000 AEs [95% CI, 0.84-1.01]; IRR, 1.26 [95% CI, 1.14-1.38]) ( P < .0001). This relationship was demonstrated consistently across all subanalyses, including stratification by NCAA division and sex. The injury rate on natural grass (0.52/10,000 AEs; 95% CI, 1.11-1.26) was significantly greater than the injury incidence during practice on artificial turf (0.06/10,000 AEs; 95% CI, 0.043-0.096). Players were 8.67 times more likely to sustain an ACL injury during practice on natural grass compared with practice on artificial turf (95% CI, 5.43-12.13; P < .0001). No significant difference was found in injury rates between matches played on grass versus turf (IRR, 0.93; 95% CI, 0.84-1.03; P = .15). Conclusion: NCAA soccer players who practice on natural grass have increased risk of ACL injury compared with the risk of those practicing on an artificial surface, regardless of sex or NCAA division of play. No difference in risk of ACL injury between playing surfaces was detected during matches. Further research is necessary to examine the effect of multiple factors when evaluating the effect of the surface type on the risk of ACL injury in soccer players.

scholarly journals The Effect Of Playing Surface On Anterior Cruciate Ligament Injury In NCAA Soccer

2020 ◽  
Vol 8 (3_suppl2) ◽  
pp. 2325967120S0012
Author(s):  
Mark Howard ◽  
Hyunwoo Paco Kang ◽  
Samantha Solaru ◽  
Alexander E. Weber ◽  
Mark F. Rick C
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Injury Incidence ◽  
Artificial Turf ◽  
Acl Injuries ◽  
Natural Grass ◽  
Significant Difference ◽  
Anterior Cruciate

Objectives: Previous orthopaedic literature has examined the effect of synthetic playing surfaces on the risk of anterior cruciate ligament (ACL) injury in athletes and produced varying and inconclusive results. The objective of this study was to examine the role of playing surface on the incidence and risk of ACL injury in collegiate soccer athletes. Methods: The NCAA Injury Surveillance Program (ISP) database was queried for ACL injuries for male and female soccer players from the 2004-05 through the 2013-14 seasons at all levels of competition. The number of athlete exposures (AEs), defined as 1 athlete participating in 1 practice or competition in which they were exposed to the possibility of athletic injury, were recorded for grass and synthetic playing surfaces. Both the reported injuries and exposures provided were weighted in order to represent the entire NCAA collegiate soccer population. Normalized ACL incidence rates were calculated as well as 95% confidence intervals (95%CI). Rate ratios comparing competition type amongst both competition and practice were calculated. Results: ACL injuries were more common on grass surfaces (1.16 per 10,000 AEs, 95%CI 1.12-1.20) than artificial turf (0.92 per 10,000 AEs, 95%CI 0.84-1.04). This difference was statistically significant (IRR 1.26, p<0.0001), and driven primarily by the difference in injury incidence during practice. The injury incidence during practice on natural grass (1.18 per 10,000 AEs, 95% CI 1.11-1.26) was significantly greater than the injury incidence rate during practice on artificial turf (0.067 per 10,000 AEs, 95%CI 0.043-0.096). Players were 17.7 times more likely (95%CI 10.6678-27.2187, p<0.0001) to sustain an ACL injury during practice on natural grass when compared to practice on artificial turf. However, there was no significant difference in injury incidence during matches (IRR 0.96, p=0.44), with matches on natural grass (3.35 per 10,000 AEs, 95% CI 3.21-3.51) equivalent to matches on artificial surfaces (3.49 per 10,000 AEs, 95%CI 3.18-3.81). When comparing exposure type, the injury rate was significantly greater during matches (3.38 per 10,000 AEs, 95% CI 3.25-3.52) compared to practices (0.82 per 10,000 AEs, 95%CI 0.77-0.88), with a 4.10-fold increase in ACL injury incidence during matches compared to practice (p<0.0001). Conclusion: Between 2004 and 2014, NCAA soccer players experienced a greater number of ACL injuries on natural grass playing surfaces compared with artificial turf playing surfaces. This difference is driven by injuries during practice, where athletes were nearly 18 times more likely to suffer an ACL injury on grass versus artificial turf. While ACL injuries were more likely during matches compared to practices, no difference in incidence was noted between playing surfaces. Additional study is warranted investigating potential causes for this observed increased risk with soccer practice on grass fields.

scholarly journals Application and Surgical Technique of ACL Reconstruction Using Worldwide Registry Datasets: What Can We Extract?

2021 ◽  
Vol 7 (1) ◽  
pp. 2
Author(s):  
Ulrike Wittig ◽  
Georg Hauer ◽  
Ines Vielgut ◽  
Patrick Reinbacher ◽  
Andreas Leithner ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Knee Injuries ◽  
Epidemiological Data ◽  
Surgical Reconstruction ◽  
Acl Injuries ◽  
Knee Ligament ◽  
Graft Choice ◽  
Anterior Cruciate ◽  
The Uk ◽  
Country Specific

Anterior cruciate ligament (ACL) injuries are among the most common knee injuries. The purpose of this study was to compare surgical reconstruction of the ACL between different countries and regions in order to describe differences regarding epidemiological data, reconstruction frequency, and graft choice. A systematic literature search was performed using the ACL study group website in order to identify the relevant knee ligament registers. Four national registries were included, comprising those from Sweden, the UK, New Zealand, and Norway. A large variation was found concerning the total number of primary ACL reconstructions with a reported range from 4.1 to 51.3 per 100,000 inhabitants. The country-specific delay between injury and reconstruction varied between an average of 6.0 months and 17.6 months. The leading sports activities resulting in ACL injury included soccer, alpine skiing, handball, rugby, and netball. Moreover, a strong variability in graft choice for primary reconstruction was found. The comparison of ACL registers revealed large differences, indicating different clinical implications regarding conservative or surgical therapy and choice of the preferable graft. ACL registers offer a real-world clinical perspective with the aim to improve quality and patient safety by investigating factors associated with subsequent surgical outcomes.

scholarly journals Effects of a Prophylactic Knee Sleeve on Anterior Cruciate Ligament Loading During Sport-Specific Movements

2019 ◽  
Vol 28 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Jonathan Sinclair ◽  
Paul J. Taylor
Keyword(s):  
Anterior Cruciate Ligament ◽  
Repeated Measures ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Musculoskeletal Modeling ◽  
Acl Injuries ◽  
Recreational Athletes ◽  
Load Rate ◽  
Anterior Cruciate ◽  
3D Motion Capture

Context: Prophylactic knee bracing is extensively utilized in athletic populations to reduce the high risk from knee injuries, but its role in the attenuation of anterior cruciate ligament (ACL) pathologies is not well understood. Objective: The aim of this investigation was to explore the effects of a prophylactic knee sleeve on ACL loading parameters linked to the etiology of injury in recreational athletes. Setting: Laboratory. Design: Repeated measures. Participants: Thirteen healthy male recreational athletes. Intervention: Participants performed run, cut, and single-leg hop movements under 2 conditions; prophylactic knee sleeve and no sleeve. Main Outcome Measures: Biomechanical data were captured using an 8-camera 3D motion capture system and a force platform. Peak ACL force, average ACL load rate, and instantaneous ACL load rate were quantified using a musculoskeletal modeling approach. Results: The results showed that both average and instantaneous ACL load rates were significantly reduced when wearing the knee sleeve in the hop (sleeve = 612.45/1286.39 N/kg/s and no sleeve = 743.91/1471.42 N/kg/s) and cut (sleeve = 222.55/1058.02 N/kg/s and no sleeve = 377.38/1183.01 N/kg/s) movements. Conclusions: Given the biomechanical association between ACL loading and the etiology of ACL injuries, it is proposed that athletes may be able to attenuate their risk from injury during cut and hop movements through utilization of a prophylactic knee sleeve.

Lower Extremity Biomechanical Differences Between Female Dancers and Soccer Players

2020 ◽  
Vol 25 (5) ◽  
pp. 254-257
Author(s):  
Hayley M. Ericksen ◽  
Rachele E. Vogelpohl
Keyword(s):  
Lower Extremity ◽  
National Collegiate Athletic Association ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Acl Injuries ◽  
Jump Landing ◽  
Ankle Eversion ◽  
Anterior Cruciate ◽  
Modern Dancers

Anterior cruciate ligament (ACL) injury in female athletes is common. Team sport athletes experience more ACL injuries than ballet and modern dancers. Examining biomechanical differences between these two groups may help to explain the discrepancy in ACL injury rates. The purpose of this study was to examine lower extremity kinematic differences between collegiate dancers and National Collegiate Athletic Association Division I soccer athletes during a rebound jump-landing task. Peak hip, knee, and ankle kinematics were collected during a jump-landing task. Results showed more knee flexion and less ankle eversion in the dancers compared to the soccer athletes. Differences in training and strategies used during landing may explain the kinematic differences between groups.

DIAGNOSING ANTERIOR CRUCIATE LIGAMENT INJURIES USING A KNEE ARTHROMETER: DESIGN, FABRICATION, AND CLINICAL EVALUATION

2011 ◽  
Vol 23 (03) ◽  
pp. 181-192
Author(s):  
Damoon Soudbakhsh ◽  
Elham Sahraei ◽  
Mehdi Bostan Shirin ◽  
Farzam Farahmand ◽  
Mohammad Naghi Tahmasebi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Knee Laxity ◽  
Ligament Injuries ◽  
Acl Injuries ◽  
Anterior Cruciate Ligament Injuries ◽  
Specificity And Sensitivity ◽  
Anterior Cruciate ◽  
The Right

Every year many people suffer from knee injuries. Previous studies on patients with knee injuries have shown that about 40% of knee injuries are Ligament injuries, and about 50% of the ligament injuries are the Anterior Cruciate Ligament (ACL) injuries. Along with other methods, knee arthrometers are widely used to diagnose ACL injuries. In the current research, a knee arthrometer was designed and developed to provide a reliable and repeatable measurement of knee laxity under anterior–posterior applied loads. Test–retest configurations to examine repeatability of the device resulted in less than 1.5-mm difference for more than 97% of tests under applied loads of up to 90 N. These tests included 166 tests on the left knees and 147 tests on the right knees of 37 healthy subjects. Also, this device was tested on 27 confirmed ACL ruptured patients, and the results were analyzed to find a better criterion than standard criteria to diagnose ACL rupture using knee arthrometers by finding specificity and sensitivity of the device using those criteria. Among the 20 criteria evaluated, a combination of side-to-side difference under 150 N of applied load, and CI@90-60 (compliance index calculated between 90 N, and 60 N) resulted in the best sensitivity (96.4%) and specificity (100%).

Evaluating Different Criteria to Diagnose ACL Rupture Using a Knee Arthrometer

2009 ◽  
Author(s):  
Damoon Soudbakhsh ◽  
Mohammad-Naghi Tahmasebi ◽  
Mohamad Parnianpour
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Acl Rupture ◽  
Ligament Injuries ◽  
Acl Injuries ◽  
Anterior Laxity ◽  
Anterior Cruciate

Every year many people suffer from knee injuries. Previous studies on patients with knee injuries has shown that about 40% percent of knee injuries are ligament injuries, and about 50% of the ligament injuries are the Anterior Cruciate Ligament (ACL) injuries [1–2]. Knee arthrometers are widely used to diagnose ACL injuries, along with other methods [3–4]. In the current research, a knee arthrometer which was developed to provide an accurate measurement of AP displacement of the knee [5] was used to measure anterior laxity of the knees of 20 subjects, and the results were analyzed to find better criteria to diagnose ACL rupture using knee arthrometers.

Multiple Ligament Knee Injuries

2018 ◽  
Vol 31 (05) ◽  
pp. 399-409 ◽  
Author(s):  
David Fanelli ◽  
Gregory Fanelli
Keyword(s):  
Knee Injury ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Organ System ◽  
Ligament Injury ◽  
Ligament Injuries ◽  
Knee Ligament ◽  
Functional Instability ◽  
Adolescent Population ◽  
Knee Ligament Injuries

AbstractThe posterior cruciate ligament (PCL)-based multiple ligament injury, or dislocated knee, is often part of a multisystem injury complex that not only includes the knee ligaments, but may also include blood vessels, skin, nerves, fractures, and other organ system trauma. These factors must be considered in the scope of treating this complex knee injury. These complex knee ligament injuries can result in significant functional instability for the affected individual. This article will discuss multiple ligament knee injuries evaluation, treatment, and special considerations in the pediatric and adolescent population.

scholarly journals Sex-Based Differences in Anterior Cruciate Ligament Injuries Among United States High School Soccer Players: An Epidemiological Study

2020 ◽  
Vol 8 (5) ◽  
pp. 232596712091917
Author(s):  
Andrew S. Gupta ◽  
Lauren A. Pierpoint ◽  
R. Dawn Comstock ◽  
Michael G. Saper
Keyword(s):  
United States ◽  
High School ◽  
Anterior Cruciate Ligament ◽  
Epidemiological Study ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Acl Injuries ◽  
Injury Rates ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are common among high school athletes, with sex-based differences accounting for higher injury rates in girls. Previous epidemiological studies on ACL injuries focusing on adolescent athletes have looked at injuries across multiple sports, but few have analyzed ACL tears in solely high school soccer athletes. Purpose: To examine sex-based differences in the epidemiology of ACL injuries among high school soccer players in the United States (US). Study Design: Descriptive epidemiological study. Methods: ACL injury data for US high school soccer players were obtained from the internet-based National High School Sports-Related Injury Surveillance Study’s High School RIO (Reporting Information Online) system. Athletic trainers from a random sample of 100 high schools from 8 strata based on US Census geographic region reported data for athlete-exposures (AEs) (practice or competition) and ACL injuries from 2007 through 2017. Injury rates were calculated as the number of ACL injuries per 100,000 AEs. Subgroup differences were evaluated with rate ratios (RRs) or injury proportion ratios (IPRs) and 95% CIs. Statistical differences in demographics between groups were examined using independent t tests. Comparisons of categorical data (ie, level of play) were performed using the Wald chi-square test. Results: The reported number of ACL injuries corresponded to weighted national estimates of 41,025 (95% CI, 33,321-48,730) ACL injuries in boys’ soccer and 110,028 (95% CI, 95,349-124,709) in girls’ soccer during the study period. The rate of injuries was higher in girls’ soccer (13.23/100,000 AEs) than boys’ soccer (4.35/100,000 AEs) (RR, 3.04 [95% CI, 2.35-3.98]). The rate of ACL injuries was higher in competition compared with practice for girls (RR, 14.77 [95% CI, 9.85-22.15]) and boys (RR, 8.69 [95% CI, 5.01-15.08]). Overall, a smaller proportion of ACL injuries were caused by player-player contact for girls (30.1%) compared with boys (48.6%) (IPR, 0.62 [95% CI, 0.41-0.93]). Conclusion: ACL injury rates and patterns in high school soccer players differed between sex, type of exposure (practice vs competition), and mechanism of injury.

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