CRISIS

ACL INJURIES CHANGE LIVES AND THREATEN FUTURES

An ACL injury involves a rupture of the ligament connecting the shin and thigh bones. The injury calls for major surgery, which carries high healthcare costs, risk of financial burden, a difficult recovery, long-term knee pain, and serious risk of knee replacement. Many do not return to their sport.

  • Most injuries require major surgery
    3 in 4 ACL injuries required reconstructive surgery*, including 83% among girls.*

  • A long recovery and psychological toll
    Surgery recovery takes 9-12 months, during which time youth face significant mental health challenges, including symptoms of depression and fear of re-injury.

  • High healthcare costs and financial burden
    While individual surgery costs $9,400, total lifetime costs exceed $38,000. Costs are even higher ($88,000) for those who receive non-operative treatment. Following surgery, 58% of families face significant financial burden, due mainly to the cost of physical therapy.

  • High likelihood of dropout
    Nearly half of those injured do not return to competitive levels of sport, with many high school athletes dropping out due to the uncertainty of a full recovery. As many as 62% of competitive female athletes have dropped out within two years.

  • Long-term knee pain and future knee replacement
    Half of youth who undergo surgery to repair their ACL will develop osteoarthritis (OA) within 20 years. Those injured are also seven times more likely to experience end-stage OA, requiring knee replacement.

*Source: Janosky et al. (in press)

WHO IS MOST VULNERABLE?

Outside of football, the vast majority of ACL injuries do not involve physical contact. Instead, these non-contact ACL injuries happen during sudden changes of direction or speed, such as when slowing down, stopping abruptly or landing from a jump. Who is most vulnerable? Girls, youth in cutting and landing sports, those with a previous ACL injury and youth from underserved communities.

  • Women & girls
    Girls consistently demonstrate higher rates of ACL injury than boys, regardless of level. At the high school level, ACL injury rates are four times higher for girls than boys in sex-comparable sports (soccer, basketball, baseball/softball). At the NCAA level, ACL injury rates are three to six times greater for girls than boys.

  • Cutting and landing sports Adolescents playing team sports that require sudden change of speed or direction face most risk of non-contact ACL injury, such as soccer, basketball, lacrosse and football.

  • Previously injured athletes
    Sport participants who underwent ACL surgery were six times more likely to suffer an ACL injury within two years.

  • Underserved youth
    Families in underserved communities face disparities in access to injury prevention and health care, especially athletic trainers and health insurance. When injured, underserved youth experience more delays in time to surgery and financial burden that affects access to physical therapy for recovery.