Epidemiology of Injuries Requiring Surgery Among High School Athletes in the United States, 2005 to 2010
ABSTRACT The proportion of high school sports-related injuries requiring surgery, which pose monetary and time loss burdens, has significantly increased during the last decade. The objective was to investigate the epidemiology of high school athletic injuries requiring surgery.
High school sports-related injury data were collected for nine sports from 2005 to 2010 from 100 nationally representative US high schools.
Athletes sustained 1,380 injuries requiring surgery for a rate of 1.45 injuries per 10,000 athlete exposures. Boys' football had the highest injury rate (2.52) followed by boys' wrestling (1.64). Among gender comparable sports, girls' sports has a higher injury rate (1.20) than boys' (0.94) (rate ratio, 1.28; 95% confidence interval, 1.08-1.51; p=0.004). The rate of injuries was higher in competition (3.23) than practice (0.79) (rate ratio, 4.08; 95% confidence interval, 3.67-4.55; p<0.001) overall and in each sport. Commonly injured body sites were the knee (49.4%), head/face/mouth (9.7%), and shoulder (8.7%). Common diagnoses were complete ligament strain (32.1%) and fracture (26.4%). Nearly half (48.0%) resulted in medical disqualification for the season.
Rates and patterns of injuries requiring surgery differ by sport, type of exposure, and gender. Future studies should identify sport-specific risk factors to drive effective interventions to decrease the incidence and severity of such injuries.
SourceAvailable from: Nicola Maffulli[Show abstract] [Hide abstract]
ABSTRACT: The increased participation of children and adolescents in organized sports worldwide is a welcome trend given evidence of lower physical fitness and increased prevalence of overweight in this population. However, the increased sports activity of children from an early age and continued through the years of growth, against a background of their unique vulnerability to injury, gives rise to concern about the risk and severity of injury. Three types of injury-anterior cruciate ligament (ACL) injury, concussion, and physeal injury - are considered potentially serious given their frequency, potential for adverse long-term health outcomes, and escalating healthcare costs. Concussion is probably the hottest topic in sports injury currently with voracious media coverage and exploding research interest. Given the negative cognitive effects of concussion, it has the potential to have a great impact on children and adolescents during their formative years and potentially impair school achievement and, if concussion management is not managed appropriately, there can be long term negative impact on cognitive development and ability to resume sports participation. Sudden and gradual onset physeal injury is a unique injury to the pediatric population which can adversely affect growth if not managed correctly. Although data are lacking, the frequency of stress-related physeal injury appears to be increasing. If mismanaged, physeal injuries can also lead to long-term complications which could negatively affect ability to participate in sports. Management of ACL injuries is an area of controversy and if not managed appropriately, can affect long-term growth and recovery as well as the ability to participate in sports. This article considers the young athlete's vulnerability to injury, with special reference to ACL injury, concussion, and physeal injury, and reviews current research on epidemiology, diagnosis, treatment, and prevention of these injury types. This article is intended as an overview of these injury types for medical students, healthcare professionals and researchers.06/2014; 6:22. DOI:10.1186/2052-1847-6-22
[Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND:There is still much that we do not know about differences in sports injuries between young male and female athletes and the factors that may increase the risk for injuries in this regard. PURPOSE:To describe and compare differences between males and females in pediatric sports-related injuries. STUDY DESIGN:Cross-sectional study; Level of evidence, 3. METHODS:A retrospective chart review was performed using a 5% random sampling (N = 2133) of medical records of children aged 5 to 17 years seen over 10 years in a sports medicine clinic at a large academic pediatric hospital. Information was collected and analyzed on age, sex, height, weight, injury type (overuse vs acute/traumatic), location of injury, and sports involvement. RESULTS:Overall, female athletes had a higher percentage of overuse injuries (62.5%) compared with traumatic injuries (37.5%); the opposite was seen in male athletes (41.9% vs 58.2%, respectively; P < .001). Looking at specific areas of injury, female athletes sustained more injuries to the lower extremity (65.8%) and spine (11.3%) as compared with male athletes (53.7% and 8.2%, respectively). Male patients had a greater percentage of injuries to the upper extremity (29.8%) as compared with female patients (15.1%). The type of hip/pelvis injuries differed greatly by sex, with females sustaining more overuse (90.9%) and soft tissue injuries (75.3%) versus males, who suffered injuries that tended to be traumatic (58.3%) and bony (55.6%) in nature. Males were more likely than females to participate in team and contact/collision sports. The percentage of females with patellofemoral knee pain was approximately 3 times greater than that of males (14.3% vs 4.0%, respectively; P < .001). Males were twice as likely as females to be diagnosed with osteochondritis dissecans (8.6% vs 4.3%, respectively; P < .001) and fractures (19.5% vs 8.2%, respectively; P < .001). The percentage of males and females who sustained an anterior cruciate ligament injury was almost equal (10.0% and 8.9%, respectively; P = .369). CONCLUSION:Sports injuries in young males and females differed by injury type, diagnosis, and body area. These results may be related to the referral patterns unique to the division of the hospital, including a high number of female dancers. Further investigation is required to better understand the injury risk in pediatric male and female athletes.The American Journal of Sports Medicine 02/2014; 42(4). DOI:10.1177/0363546514522393 · 4.70 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND:High school and professional athletes with a history of orthopaedic surgery have decreased career lengths and are at a greater risk for reinjury compared with their peers. It is unknown whether the same risk applies to intercollegiate athletes. PURPOSE:To determine the effect of prior knee surgery in National Collegiate Athletic Association (NCAA) Division I athletes in the United States. STUDY DESIGN:Cohort study; Level of evidence, 3. METHODS:Division I athletes who began participation in collegiate athletics at a single institution from fall 2003 to spring 2008 were identified. Athletes with a history of orthopaedic surgery were identified through preparticipation evaluation forms. Data on the number of seasons and games played, number of days missed, diagnostic imaging, athletic injuries sustained, and surgical operations during college were collected through medical records and the Sports Injury Monitoring System (SIMS). RESULTS:During the 5-year study period, 456 athletes completed preparticipation evaluation forms. Of these, 104 athletes (22.8%) had a history of orthopaedic surgery (Ortho group). Forty-eight (10.5% of all athletes) had a history of knee surgery (Knee group), 16 (3.5%) had a history of anterior cruciate ligament reconstruction (ACL group), and 28 (6.1%) had a history of multiple surgeries (Multiple group). Days missed per season due to any injury and due to knee injury were increased for all surgical groups compared with controls (P < .016). The rate of knee injury and knee surgery while in college was significantly increased for all surgery groups. Athletes in the Knee and ACL groups were 6.8- and 19.6-fold more likely to sustain a knee injury and 14.4- and 892.9-fold more likely to undergo a knee surgery during their collegiate careers compared with controls (P < .001). The number of MRIs per season were 0.83 for the Knee group (P < .001), 1.29 for the ACL (P = .009), and 0.97 for the Multiple group (P < .001), compared with 0.37 for controls. Average career length and percentage of games played were not significantly different between any of the surgery groups compared with controls. CONCLUSION:Athletes who had a history of knee surgery before participation in collegiate athletics miss more days due to injury, have increased rates of knee injury and knee surgery, and require more MRIs during their collegiate careers than their peers.The American Journal of Sports Medicine 02/2014; 42(4). DOI:10.1177/0363546513519951 · 4.70 Impact Factor