The Incidence and Etiology of Anterior Cruciate Ligament Injuries in Patients under the Age of 18 in the State of Wisconsin

Abstract

Background: ACL injuries can have long-term effects on the musculoskeletal system, causing early osteoarthritis, and are of particular concern in children and adolescents as competitive sports participation increases. Purpose: The objective of this paper was to determine the incidence and characteristics of Anterior Cruciate Ligament (ACL) reconstructions in children in the state of Wisconsin. Methods: Wisconsin Hospital Association inpatient and ambulatory surgery data from January 2006 through December 2010 was used to identify the number of ACL reconstructions performed in pediatric patients younger than 18 years of age in the State of Wisconsin. Incidence rates were computed using US Census Bureau Population Estimates. A retrospective chart review was performed on pediatric patients younger than 18 years of age who underwent an ACL reconstruction at a single tertiary care pediatric center to abstract injury causation information. Results: Between 2006 and 2010, 4059 ACL reconstructions occurred in pediatric patients younger than 18 years of age in Wisconsin. The incidence of ACL reconstructions averaged 56.7 per 100,000 children per year. The mean age over the five years of the study was 15.4-15.9 for both males and females. ACL reconstructions increased significantly by an average of 6% each year, with females 40% more likely than males to have had a reconstruction, and older children significantly more likely to have reconstruction than children 0-11 years old (12-13 years incidence rate ratio=20.1; 14-17 years incidence rate ratio=123.0). Among the chart reviewed cases, sixty-eight percent of ACL tears occurred during organized sporting activities and 68% were caused by a non-contact injury. Conclusion: ACL tears increased significantly in Wisconsin children from 2006 to 2010. Interventions to prevent ACL injuries in children need to be developed and tested and better tracking of injuries is needed to increase understanding of risk.