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Natural history of an anterior cruciate ligament injury: associated injuries and consequences of rotational instability

Published in N°016 - March / April 2022
Article viewed 51 times

Natural history of an anterior cruciate ligament injury: associated injuries and consequences of rotational instability

By César Praz, Alexandre Ferreira, Martin Tripon, Christophe Hulet in category UPDATE
Orthopedic Department and Traumatology INSERM U1075 COMETE « Mobilité : Attention, Orientation & Chronobiologie » Caen University Lower Normandy - Caen University Hospital. Côte de Nacre Avenue - 14000 CAEN / [email protected]

In 2019, 45,997 patients in France underwent anterior cruciate ligament (ACL) reconstruction, 60% of whom underwent outpatient surgery (Source ATIH).
The incidence of ACL injury in sports populations varies based on studies of 10–65/100,000 persons. The incidence is higher (241/100,000 persons) in at-risk populations that are 19 to 25 years of age and practicing pivotal contact sports.

Epidemiology

In 2019, 45,997 patients in France underwent anterior cruciate ligament (ACL) reconstruction, 60% of whom underwent outpatient surgery (Source ATIH).

The incidence of ACL injury in sports populations varies based on studies of 10–65/100,000 persons. The incidence is higher (241/100,000 persons) in at-risk populations that are 19 to 25 years of age and practicing pivotal contact sports (1–4). Studies suggest that the annual incidence of ACL injury has not changed among American athletes since the mid-1990s (5–7).

The incidence of ACL injury by gender is not well established in the general population but does appear to be higher in female athletes playing contact sports (8). In the general population, a higher incidence is found in men (4).

A study conducted in the United States found that the societal cost is 2.3 times higher for patients who do not receive ACL reconstruction surgery than those who do, as reflected by direct rehabilitation and indirect work-related costs (9).

 

Anatomy and biomechanics

The ACL is a dense connective tissue band, approximately 3.5 cm in length, that extends from the femur to the tibia. It resists the anterior translational and internal rotational loads of the tibia and is thus a pivotal structure of the knee joint. The ACL has a...

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