Epidemiology of Anterior Cruciate Ligament Injury on Natural Grass Versus Artificial Turf in Soccer: 10-Year Data From the National Collegiate Athletic Association Injury Surveillance System
Howard M, Solaru S, Kang HP, Bolia IK, Hatch GFR, Tibone JE, Gamradt SC, Weber AE
Orthopaedic journal of sports medicine · 15 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- Authors
- At least one author declares a financial tie to industry
Based on full-text disclosure statement.
Publication
- Published
- 2020-07-01 · Orthop J Sports Med · vol. 8 · issue 7 · p. 2325967120934434
- Publisher
- SAGE Publishing
- Cited
- 39 citations · more than 84% of similar papers · 1.9× the field average
- References
- 23 works
- Access
- Open access (journal) · CC-BY-NC-ND
- Research areas
- Sports injuries and prevention · Knee injuries and reconstruction techniques · Exercise and Physiological Responses
- Keywords
- Anterior cruciate ligament, ACL injury, Medicine, Rate ratio, Physical therapy, Incidence (geometry), Sports medicine, Demography, Surgery, Internal medicine, Confidence interval
8 authors
From US
- Mark HowardKeck Hospital of USC
- Samantha A. SolaruUniversity of Southern California
- Hyunwoo Paco KangKeck Hospital of USC
- Ioanna K. BoliaKeck Hospital of USC
- George F. Rick HatchKeck Hospital of USC
- James Eugene TiboneKeck Hospital of USC
Abstract
Background
Anterior cruciate ligament (ACL) injury is prevalent among National Collegiate Athletic Association (NCAA) soccer players. Controversy remains regarding the effect of the surface type on the rate of ACL injury in soccer players, considering differences in sex, type of athletic exposure, and level of competition.
Hypothesis
Natural grass surfaces would be associated with decreased ACL injury rate in NCAA soccer players. Sex, type of athletic exposure (match vs practice), and level of competition (Division I-III) would affect the relationship between playing surface and ACL injury rates.
Study design
Cohort study; Level of evidence, 3.
Methods
Using the NCAA Injury Surveillance System (ISS) database, we calculated the incidence rate of ACL injury in men and women from 2004-2005 through 2013-2014 seasons. The incidence was normalized against athletic exposure (AE). Additional data collected were sex, athletic activity at time of injury (match vs practice), and level of competition (NCAA division) to stratify the analysis. Statistical comparisons were made by calculating incidence rate ratios (IRR). Statistical significance was set at an alpha of .05.
Results
There were 30,831,779 weighted AEs during the study period. The overall injury rate was 1.12 ACL injuries per 10,000 AEs (95% CI, 1.08-1.16). Women comprised 57% of the match data (10,261 games) and 55% of practice data (26,664 practices). The overall injury rate was significantly higher on natural grass (1.16/10,000 AEs; 95% CI, 1.12-1.20) compared with artificial turf (0.92/10,000 AEs [95% CI, 0.84-1.01]; IRR, 1.26 [95% CI, 1.14-1.38]) (P P P = .15).
Conclusion
NCAA soccer players who practice on natural grass have increased risk of ACL injury compared with the risk of those practicing on an artificial surface, regardless of sex or NCAA division of play. No difference in risk of ACL injury between playing surfaces was detected during matches. Further research is necessary to examine the effect of multiple factors when evaluating the effect of the surface type on the risk of ACL injury in soccer players.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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