Epidemiology

The estimated US incidence is 100,000 to 200,000 ACL tears per year, with 100,000 ACL reconstructions per year.[9] About 70% of ACL tears occur during sports activities. Based on US National Collegiate Athletic Association date from 2004 to 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] Non- or minimal-contact injuries account for most ACL injuries (up to 70%), especially in females.[1][10]​​[16][17]​​ One study suggests a higher rate for white European American basketball players than for nonwhite players.[18]

The 15 to 45 years age group is at highest risk. Injuries occur primarily among active people, especially in sports involving cutting, pivoting, and decelerating (e.g., soccer, basketball, skiing) or contact (e.g., football). 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]

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