The incidence of ACL reconstruction procedures has increased markedly over the the last 16 years and has been most pronounced in females aged 15-19.
Anterior cruciate ligament (ACL) injuries cause significant morbidity, and may be increasing in incidence as participation in high-risk sports increases. Many studies have reported the incidence of ACL reconstruction, but few have investigated the change in incidence and demographic patterns in a population over time. The aims of this study were to determine the incidence of ACL reconstruction surgery in New Zealand and to analyse changes to demographic subgroups over time.
In New Zealand, nearly all ACL reconstruction procedures are funded by a single government payer, the Accident Compensation Corporation (ACC), through a no-fault injury scheme. Data from this source on 20,751 primary ACL reconstruction procedures was collected from January 1st 2009 to December 31st 2016. Baseline population data was obtained from national census data to calculate the incidence, and results were compared to ACC data on 5884 primary ACL reconstructions performed between 1 July 2000 and 30 June 2005.
The annual incidence of ACL reconstruction 2009-16 was 58.2 per 100,000 person-years, and was greater in males than in females (72.2 and 44.9 respectively). This represents a 58% increase over the annual incidence of 36.9 per 100,000 person-years between 2000-05. The peak incidence occurred between ages 20-24 in males and 25-29 in females during 2000-05, changing to 20-24 in males and 15-19 in females 2009-2016. The percentage of injuries caused by sporting activities changed from 65% during 2000-05 to 76% between 2009-2016, with soccer, rugby, and netball accounting for the highest number of injuries.
The incidence of ACL reconstruction procedures has increased markedly over the the last 16 years. The increase has been most pronounced in females aged 15-19, and a greater proportion of procedures are now due to sport-related injuries. This increased incidence of ACL reconstruction may reflect higher surgical intervention rates and changes in participation in high-impact sports.