Knee ligament injury more common in inexperienced or unfit skiers

New research has shown that tears of the anterior cruciate ligament (ACL) in the knee are about twenty times more common in recreational Alpine skiers than in expert skiers. US researchers pooled the results from 33 studies dealing with ACL tears. They looked at the injury in terms of sport, gender and training. They also found that ACL tears were more common in recreational skiers than in basketball, soccer and lacrosse players. ...Interestingly, they found that the rate of tears was the same in male and female skiers, which is unusual. Most research has found the injury is generally more common in women.

Citation: Prodromos CC et al. A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen. Arthroscopy 2007; 23: 1320-5.

Abstract: http://www.ncbi.nlm.nih.gov/pubmed/18063176?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

A BBC report today has also highlighted the risk of skiing and knee injuries. Steve Bollen, president of the British Orthopaedic Sports Trauma Association, has claimed that a boom in short skiing holidays abroad is leading to a rapid increase in knee injuries.

He blames poor fitness among beginners, describing many of the serious ligament injuries he sees as "half-term syndrome".

Mr Bollen, an orthopaedic surgeon at Bradford Royal Infirmary, has conducted a study of more than 200 patients with ACL or medial ligament injuries in his clinic. He found that, while rugby and football were still the biggest culprits, the percentage of such injuries linked to skiing had soared from 9% in 1994 to 28% in 2004. More than nine out of ten of the injured skiers were women.

From: http://news.bbc.co.uk/1/hi/health/7178561.stm

Background information

The anterior cruciate ligament is in the centre of the knee joint and controls rotation. It is, therefore, vulnerable to excessive twisting movements. It can also be injured when there is a large sideways movements of the joint. Such movements will initially injure the ligaments on the inside (medial collateral ligament, MCL) or outside (lateral collateral ligament, LCL) of the joint but, as the joint opens out excessively, the ACL can also be torn.

Not surprisingly, the common sports that produce this injury are football, rugby, skiing, basketball and netball. Women are generally at greater risk than men; the cause for this is not completely understood, but it may be due to differences in anatomy and muscular function.

Typically, when the ACL is ruptured, there is a feeling or hearing of a pop or snap, or something tearing when the knee undergoes a twisting movement while running or landing from a jump, or if there is a blow from the side of the knee. It is not usually possible to carry on after the injury, and if it is, the knee will soon collapse. The knee then swells within 4 hours. The swelling then takes a couple of weeks to settle and a return to activity is possible, but only in straight lines. If an attempt to change direction at speed is made, the knee feels as if it comes apart.

Damage to the ligaments that hold the knee together can require surgery to repair, and if left untreated, can cause irreparable damage to the joint.

Link to British Orthopaedic Sports trauma Association article on ACL injury: http://www.bosta.ac.uk/article.asp?article=20