Cargando…

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

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,...

Descripción completa

Detalles Bibliográficos
Autores principales: Howard, Mark, Solaru, Samantha, Kang, Hyunwoo P., Bolia, Ioanna K., Hatch, George F.R., Tibone, James E., Gamradt, Seth C., Weber, Alexander E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376298/
https://www.ncbi.nlm.nih.gov/pubmed/32743012
http://dx.doi.org/10.1177/2325967120934434
_version_ 1783562015854297088
author Howard, Mark
Solaru, Samantha
Kang, Hyunwoo P.
Bolia, Ioanna K.
Hatch, George F.R.
Tibone, James E.
Gamradt, Seth C.
Weber, Alexander E.
author_facet Howard, Mark
Solaru, Samantha
Kang, Hyunwoo P.
Bolia, Ioanna K.
Hatch, George F.R.
Tibone, James E.
Gamradt, Seth C.
Weber, Alexander E.
author_sort Howard, Mark
collection PubMed
description 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 < .0001). This relationship was demonstrated consistently across all subanalyses, including stratification by NCAA division and sex. The injury rate on natural grass (0.52/10,000 AEs; 95% CI, 1.11-1.26) was significantly greater than the injury incidence during practice on artificial turf (0.06/10,000 AEs; 95% CI, 0.043-0.096). Players were 8.67 times more likely to sustain an ACL injury during practice on natural grass compared with practice on artificial turf (95% CI, 5.43-12.13; P < .0001). No significant difference was found in injury rates between matches played on grass versus turf (IRR, 0.93; 95% CI, 0.84-1.03; 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.
format Online
Article
Text
id pubmed-7376298
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-73762982020-07-31 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, Mark Solaru, Samantha Kang, Hyunwoo P. Bolia, Ioanna K. Hatch, George F.R. Tibone, James E. Gamradt, Seth C. Weber, Alexander E. Orthop J Sports Med Article 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 < .0001). This relationship was demonstrated consistently across all subanalyses, including stratification by NCAA division and sex. The injury rate on natural grass (0.52/10,000 AEs; 95% CI, 1.11-1.26) was significantly greater than the injury incidence during practice on artificial turf (0.06/10,000 AEs; 95% CI, 0.043-0.096). Players were 8.67 times more likely to sustain an ACL injury during practice on natural grass compared with practice on artificial turf (95% CI, 5.43-12.13; P < .0001). No significant difference was found in injury rates between matches played on grass versus turf (IRR, 0.93; 95% CI, 0.84-1.03; 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. SAGE Publications 2020-07-22 /pmc/articles/PMC7376298/ /pubmed/32743012 http://dx.doi.org/10.1177/2325967120934434 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Howard, Mark
Solaru, Samantha
Kang, Hyunwoo P.
Bolia, Ioanna K.
Hatch, George F.R.
Tibone, James E.
Gamradt, Seth C.
Weber, Alexander E.
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376298/
https://www.ncbi.nlm.nih.gov/pubmed/32743012
http://dx.doi.org/10.1177/2325967120934434
work_keys_str_mv AT howardmark epidemiologyofanteriorcruciateligamentinjuryonnaturalgrassversusartificialturfinsoccer10yeardatafromthenationalcollegiateathleticassociationinjurysurveillancesystem
AT solarusamantha epidemiologyofanteriorcruciateligamentinjuryonnaturalgrassversusartificialturfinsoccer10yeardatafromthenationalcollegiateathleticassociationinjurysurveillancesystem
AT kanghyunwoop epidemiologyofanteriorcruciateligamentinjuryonnaturalgrassversusartificialturfinsoccer10yeardatafromthenationalcollegiateathleticassociationinjurysurveillancesystem
AT boliaioannak epidemiologyofanteriorcruciateligamentinjuryonnaturalgrassversusartificialturfinsoccer10yeardatafromthenationalcollegiateathleticassociationinjurysurveillancesystem
AT hatchgeorgefr epidemiologyofanteriorcruciateligamentinjuryonnaturalgrassversusartificialturfinsoccer10yeardatafromthenationalcollegiateathleticassociationinjurysurveillancesystem
AT tibonejamese epidemiologyofanteriorcruciateligamentinjuryonnaturalgrassversusartificialturfinsoccer10yeardatafromthenationalcollegiateathleticassociationinjurysurveillancesystem
AT gamradtsethc epidemiologyofanteriorcruciateligamentinjuryonnaturalgrassversusartificialturfinsoccer10yeardatafromthenationalcollegiateathleticassociationinjurysurveillancesystem
AT weberalexandere epidemiologyofanteriorcruciateligamentinjuryonnaturalgrassversusartificialturfinsoccer10yeardatafromthenationalcollegiateathleticassociationinjurysurveillancesystem