Epidemiology of Knee Injuries Among Boys and Girls in US High School Athletics

Williams College, Williamstown, Massachusetts, USA.
The American Journal of Sports Medicine (Impact Factor: 4.36). 07/2008; 36(6):1116-22. DOI: 10.1177/0363546508314400
Source: PubMed


The knee joint is the second most commonly injured body site and the leading cause of high school sports-related surgeries. Knee injuries are among the most economically costly sports injuries and may require subsequent surgery or extensive and expensive rehabilitation.
To report the incidence, risk, and severity of high school knee injuries across sports, genders, and type of exposure.
Descriptive epidemiology study.
During the 2005-2006 and 2006-2007 school years, 100 US high schools were randomly selected for a nationally representative sample. Certified athletic trainers tracked injuries using an online injury surveillance system, High School RIO, in 9 high school sports.
There were 1383 knee injuries reported during 3,551131 athlete exposures for a rate of 3.89 knee injuries per 10,000 athlete exposures. Although boys had a higher overall rate of knee injury (rate ratio, 1.38; confidence interval, 1.22-1.55), girls were twice as likely to sustain knee injuries requiring surgery (major knee injuries) than were boys (injury proportion ratio, 1.98; confidence interval, 1.45-2.70) and twice as likely to incur noncontact major knee injuries (injury proportion ratio, 1.98; confidence interval, 1.23-3.19) as were boys. Although illegal play was identified as a contributing factor in only 5.7% of all knee injuries, 20% of knee injuries resulting from illegal play required surgery.
Knee injury rates and patterns varied by sport, gender, and type of exposure. Identified gender differences included differences in injury rates, injury severity, and basic injury mechanism. Further surveillance is crucial for the development of targeted, evidence-based injury prevention strategies to reduce the morbidity and economic impact of knee surgeries.

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    • "Analysis of youth sport injury studies indicates that most injuries involve the knee and ankle [14]. For example, in a representative sample of 100 United States high schools involved in 9 sports during 2005–2007, ankle injury was most common (20.9%), followed by the knee (15.2%) [15]. However, the knee was the most common severely injured (more than 21 days’ time loss) location (29%), accounting for 44.6% of all surgeries [16]. "
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    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(1):22. DOI:10.1186/2052-1847-6-22
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    • "Knee injuries are common in young individuals and usually result in pain or some degree of loss in athletic capacities [12]. These sequelae can be quantified or measured using knee scores or scales, such as the International Knee Documentation Committee (IKDC) Subjective Knee Form [13], Tegner Activity Scale [35], Marx Activity Rating Scale [24], Kujala Anterior Knee Pain Scale [18], and Knee Injury and Osteoarthritis Outcome Score (KOOS) [34]. "
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    ABSTRACT: BACKGROUND: The Lysholm knee scale, first published in 1982, is an eight-item questionnaire designed to evaluate patients after knee ligament injury. However, as a tool developed in English, its use as a validated instrument has been limited to English-language populations. QUESTIONS/PURPOSES: The objectives of this study were to test the ease of use, reliability, and validity of a Turkish-language, culturally adapted version of the Lysholm knee scale. METHODS: The Lysholm knee scale was translated into Turkish according to Guillemin's recommendations. Seventy patients (mean age, 36 years; range, 17-72 years) with different knee complaints were included, and the scale was completed twice by each participant at 3- to 14-day intervals to assess test-retest reliability based on the interrater correlation coefficient, whereas Cronbach's alpha evaluated internal consistency. External validity was evaluated with correlations between the Lysholm knee scale, Kujala Anterior Knee Pain Scale, and SF-36. The distribution of floor and ceiling effects was determined. RESULTS: Patients completed the Turkish-language Lysholm questionnaire in approximately 3 minutes. The test-retest reliability was 0.82, with a Cronbach's alpha coefficient of 0.68. The Lysholm knee score was strongly correlated with the Kujala Anterior Knee Pain Scale (r = 0.78). The Turkish Lysholm knee scale showed high correlations with the SF-36 physical component score (r = 0.61) and a low association with the mental component domain (r = 0.14). CONCLUSIONS: The Turkish version of the Lysholm knee scale is quickly administered, valid, and reliable, and can be used for patients with various knee disorders. LEVEL OF EVIDENCE: Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
    Clinical Orthopaedics and Related Research 05/2013; 471(8). DOI:10.1007/s11999-013-3046-z · 2.77 Impact Factor
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    • "However, in soccer, the extensor and flexor muscles of the lower limbs take on extreme importance to stabilization, with a tendency toward a preference of the extensors over the flexors, which generally reflects in a significant force deficit among the flexors, making them more vulnerable, especially during a jump [1]. It has been hypothesized that the increase in the varus/valgus angle, together with instability and an increase in proximal force in the shearing of the tibia may be a determinant for taller athletes having a greater rate of injury with regard to this variable [22]. "
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    ABSTRACT: Background The participation of children and adolescents in sports has become increasingly frequent, including soccer. This growing involvement gives rise to concerns regarding the risk of sports injuries. Therefore, the aim of the present study was to describe the musculoskeletal injuries in young soccer players. Methods 301 male soccer players with a mean age 14.67 ± 2.08 years were randomly recruited. The Referred Condition Inquiry was used to collect information on the mechanism of injury and anatomic site affected as well as personal data on the participants. The variables were analyzed based on the degree of association using Goodman’s test for contrasts between multinomial populations, with the p < 0.05. Results Among the 301 athletes, 24.25% reported at least one injury. With regard to height, taller individuals reported more injuries than shorter individuals (62.5% and 37.5%, respectively; p < 0.05). Injuries were more frequent among players with a training duration greater than five years (69.65%) in comparison to those who trained for a shorter duration (30.35%) (p < 0.05). The lower limbs, especially the ankle/foot and knee, were the most affected anatomic sites. Impact was the most common mechanism of injury. Conclusion The young practitioners of soccer analyzed had low rates of injury. The main causal mechanism was the impact. A taller height and longer exposure to training were the main risk factors for injury among young soccer players.
    International Archives of Medicine 04/2013; 6(1):14. DOI:10.1186/1755-7682-6-14 · 1.08 Impact Factor
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