Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer: a 13-year review

Julie Agel, Elizabeth A Arendt, Boris Bershadsky
American Journal of Sports Medicine 2005, 33 (4): 524-30

BACKGROUND: Female collegiate athletes have been reported to have a higher rate of anterior cruciate ligament injury compared to male collegiate athletes. This finding has spawned a branch of research focused on understanding and preventing this injury pattern.

PURPOSE: To determine if the trends reported in 1994 have continued.

STUDY TYPE: Descriptive epidemiology study.

METHODS: The National Collegiate Athletic Association Injury Surveillance System database was reviewed for all data relating to men's and women's basketball and soccer anterior cruciate ligament injuries for 1990 to 2002.

RESULTS: No significant difference was seen in basketball comparing frequency of contact versus noncontact injuries between men (70.1%) and women (75.7%). Male basketball players sustained 37 contact injuries and 78 noncontact injuries. Female basketball players sustained 100 contact injuries and 305 noncontact injuries. In soccer, there was a significant difference in frequency of injury for male (49.6%) and female (58.3%) athletes when comparing contact and noncontact injuries (chi2=4.1, P<.05). Male soccer players sustained 72 contact injuries and 66 noncontact injuries. Female soccer players sustained 115 contact injuries and 161 noncontact injuries. The magnitude of the difference in injury rates between male and female basketball players (0.32-0.21, P=.93) remained constant, whereas the magnitude of the difference in the rate of injuries between male and female soccer players (0.16-0.21, P=.08) widened. Comparing injury within gender by sport, soccer players consistently sustained more anterior cruciate ligament injuries than did basketball players. The rate of anterior cruciate ligament injury for male soccer players was 0.11 compared to 0.08 for male basketball players (P=.002). The rate of anterior cruciate ligament injury for female soccer players was 0.33 and for female basketball players was 0.29 (P=.04). The rates for all anterior cruciate ligament injuries for women were statistically significantly higher (P<.01) than the rates for all anterior cruciate ligament injuries for men, regardless of the sport. In soccer, the rate of all anterior cruciate ligament injuries across the 13 years for male soccer players significantly decreased (P=.02), whereas it remained constant for female players.

CONCLUSIONS: In this sample, the rate of anterior cruciate ligament injury, regardless of mechanism of injury, continues to be significantly higher for female collegiate athletes than for male collegiate athletes in both soccer and basketball.

CLINICAL RELEVANCE: Despite vast attention to the discrepancy between anterior cruciate ligament injury rates between men and women, these differences continue to exist in collegiate basketball and soccer players. Also demonstrated is that although the rate of injury for women is higher than for men, the actual rate of injury remains low and should not be a deterrent to participation in sports.

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