Epidemiology

The estimated annual incidence of ACL tears in the US is 68.6 per 100,000 person-years.[9]​ About 70% of ACL tears occur during sports activities. Based on US National Collegiate Athletic Association data from 2004-2013, the highest average annual rate of injury was 0.17 per 1000 athlete-exposures for men and 0.23 for women.[10]​

The female-to-male ratio has generally ranged from 2:1 to 8:1, and varies across sports.[11]​[12]​[13]​[14]​[15]​ One systematic review and meta-analysis found that among sex-comparable sports, female adolescent athletes are 1.5 times as likely as male adolescent athletes to sustain an ACL injury.[16]​ Non- or minimal-contact injuries account for most ACL injuries (up to 70%), especially in females.[1]​[10]​[17]​[18]​ One study suggests a higher rate for white European American basketball players than for non-white players.[19]​

The 15- to 45-year-old age group is at highest risk. In one national registry of 18,668 patients with anterior cruciate ligament (ACL) injury, the average age of patients undergoing ACL reconstruction surgery was 30.[20]​ Injuries occur primarily among active people, especially in sport involving cutting, pivoting, and decelerating (e.g., soccer, basketball, skiing) or contact (e.g., rugby). Non-sports related activities resulting in ACL injury include falls, work-related injuries, and road traffic accidents.[20]​ In children, falling off of a bike while trying to plant the ipsilateral foot is a common mechanism of ACL avulsion from the tibial eminence.[8]

The estimated annual incidence of ACL tears in the US is 68.6 per 100,000 person-years.[9]​ About 70% of ACL tears occur during sports activities. Based on US National Collegiate Athletic Association data from 2004-2013, the highest average annual rate of injury was 0.17 per 1000 athlete-exposures for men and 0.23 for women.[10] The female-to-male ratio has generally ranged from 2:1 to 8:1, and varies across sports.[11][12][13][14][15]​ ​ One systematic review and meta-analysis found that among sex-comparable sports, female adolescent athletes are 1.5 times as likely as male adolescent athletes to sustain an ACL injury.[16]​ Non- or minimal-contact injuries account for majority of ACL injuries (up to 70%), especially in females.[1][10][17][18]​​​​ One study suggests a higher rate for white European American basketball players than for non-white players.[19]

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