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UNC study: Sharp jump in number of ACL tears among teens

Posted July 12

— The rate of ACL tears among teenagers is up sharply in the last decade plus, according to a study published Wednesday by researchers at the University of North Carolina at Chapel Hill School of Medicine.

Females ages 13 to 17 have experienced a 59 percent increase in the number of required reconstruction procedures over the last 13 years, researchers said.

The study is the result of a collaboration of researchers from UNC School of Medicine and Gillings School of Public Health. In compiling the data, researchers analyzed a database containing private insurance claims from 148 million Americans. The number of anterior cruciate ligament reconstruction operations was up in males aged 13-17 as well, but it was not as sharp a jump as seen in females.

This age range is associated with the more intense athletic competition of high school and travel teams. Researchers say they hope the study will lead to more widespread adoption of injury prevention programs which have been shown to reduce injuries.

“Sports are important for so many reasons, and while continuing to promote sports participation and physical activity, it’s important that we implement strategies to reduce the risk of injury,” lead study author Mackenzie Herzog said in a statement.

Senior author Dr. Jeffrey Spang, associate professor of orthopaedics at the UNC School of Medicine, said there is a lack of understanding among coaches who think injury prevention programs require specialized training or equipment in order to be effective.

Sprang says most youth coaches can facilitate these programs during warm-up drills with their teams.

“These prevention programs mostly involve warm-ups and specific exercises based on balance and jumping,” Spang said. “I have three daughters who play in local soccer leagues, and I know getting injury prevention programs standardized across large organizations is challenging, but it’s important for parents and athletes to encourage their coaches and organizations to integrate an evidence-based program at all levels of sports participation.”

ACL knee injury

After the injury

Researchers said initial injury, surgery and recovery is only about half of the story for young athletes.

For ACL injuries, there are many so-called "secondary burdens."

“Females have both a higher rate of re-tear and a higher rate of injury to the other knee,” Spang said. “More than 10 percent of adolescent females who undergo an ACL reconstruction will require a second operation somewhere down the line.”

Both males and females are also at risk for long-term complications. Research suggests that about half of people who tear an ACL will go on to develop radiographic arthritis within 10 years, Spang said.

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