Purpose: Females are at greater risk for anterior cruciate ligament (ACL) injury than males. Soccer may be a significant risk factor for ACL injury in adolescent females. ACL injury has significant consequences, including early onset of osteoarthritis. The purpose of the study was to determine
the number of ACL reconstruction surgeries performed on females between the ages of 13–18 inclusive in the Capital Health (CH) region from December 2000 to November 2005, and
those due to soccer injuries.
Secondly, we describe factors relating to the mechanism of injury.
Method: Utilizing regional administrative data, we performed a standardized chart review and telephone interviews with female adolescents who underwent ACL reconstruction in the aforementioned time period. Information gathered included:
Age at reconstruction procedure.
Indoor versus outdoor soccer playing surface.
Level of play and frequency of participation.
The Alberta Soccer Association provided the number of registrants in indoor and outdoor seasons over the same time period.
Results: 2,824 ACL reconstruction operations were performed between December 2000 and November 2005. Reconstructions in females took place at an earlier age than in males. There were 266 ACL reconstructions in 256 adolescent females, of which 253 charts were available for review. One hundred and eleven (44%) knees were injured during soccer play. Seven patients with eight ACL reconstructions who injured their ACL playing soccer could not be located. ACL injuries occurred during indoor soccer in 52 (51%) cases despite higher registration in outdoor soccer during the same time-frame. 77 (74%) subjects played competitively and 81 (79%) subjects played two or more times/week.
Conclusion: Approximately 10% of ACL reconstructions were performed on adolescent females. Nearly 50% of ACL injuries occurred during soccer play, with a similar number seen in indoor versus outdoor play. Study limitations include the use of administrative data to assess the number of ACL reconstructions rather than ACL injuries. An awareness of the propensity of knee injuries in female soccer players is important. With the increased participation of young females in soccer and the serious lifelong implications of ACL rupture, prevention and training should be improved to lower the incidence of injury.
