OA warning over sharp rise in ACL reconstruction in young

Orthopaedic surgeons have expressed concern at a sharp rise in the number of anterior cruciate ligament (ACL) reconstructions taking place in young Australians, describing it as an emerging public health problem that could easily be prevented.

The population-level data analysis published in the MJA this week found the rate of reconstruction in Australians under the age of 25 has risen by a staggering 74% over the past 15 years.

The greatest increase was seen in children aged between 5 and 14 with the figures revealing an annual growth in incidence of 7.7% for boys and 8.8% for girls.

“The short-term consequences of ACL rupture include the inability to participate in sport, reconstructive surgery, and prolonged rehabilitation. In the long term … almost all individuals who tear an ACL are at increased risk of osteoarthritis and disability, and this risk is substantially increased by concurrent meniscal injury,” wrote the research team led by  Associate Professor Christopher Vertullo, director of Knee Research Australia and Chair of the Australian Orthopaedic Association Youth Sports Injury Prevention Initiative.

According to the researchers, most reconstructions could be averted by by neuromuscular agility training and other preventive measures.

Prevention is much more cost-effective than either ACL reconstruction or rehabilitation. Establishing a national ACL injury prevention program has been reported as a cost-effective strategy for improving sporting health outcomes for young Australians,” they said.  

Their findings also justified the creation of a national ACL injury prevention program and reconstruction registry, they added.

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