title: The incidence of anterior cruciate ligament injuries among competitive Alpine skiers: a 25-year investigation.
abstract: BACKGROUND
  Little is known about the evolution of anterior cruciate ligament injury rates among elite alpine skiers.
  
  
  OBJECTIVE
  To evaluate epidemiologic aspects of anterior cruciate ligament injuries among competitive alpine skiers during the last 25 years.
  
  
  METHODS
  Descriptive epidemiology study.
  
  
  METHODS
  Data were collected from elite French national teams (379 athletes: 188 women and 191 men) from 1980 to 2005.
  
  
  RESULTS
  Fifty-three of the female skiers (28.2%) and 52 of the male skiers (27.2%) sustained at least 1 anterior cruciate ligament injury. The overall anterior cruciate ligament injury incidence was 8.5 per 100 skier-seasons. The primary anterior cruciate ligament injury rate was 5.7 per 100 skier-seasons. The prevalence of reinjury (same knee) was 19%. The prevalence of a bilateral injury (injury of the other knee) was 30.5%. At least 1 additional anterior cruciate ligament surgery (mean, 2.4 procedures) was required for 39% of the injured athletes. Men and women were similar with regard to primary anterior cruciate ligament injury rate (P = .21), career remaining after the injury (P = .44), and skiing specialty (P = .5). There were more anterior cruciate ligament injuries (primary, bilateral, re-injuries) among athletes ranking in the world Top 30 (P < .001). Anterior cruciate ligament-injured athletes had a career length of 7.5 years, whereas athletes with no anterior cruciate ligament injury had a career of 4.5 years (P < .001). Finally, injury rates remained constant over time.
  
  
  CONCLUSIONS
  Anterior cruciate ligament injury rates (primary injury, bilateral injury, reinjury) among national competitive alpine skiers are high and have not declined in the last 25 years. Finding a way to prevent anterior cruciate ligament injury in this population is a very important goal.
authors.affiliation: Orthopaedic Department, Hopital Andre Mignot, Le Chesnay, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Pujol
authors.forename: Marie Philippe Rousseaux
authors.initials: MP
authors.lastname: Blanchi
authors.forename: Pierre
authors.initials: P
authors.lastname: Chambat
mesh_terms: D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000453:epidemiology*; D003163:Competitive Behavior; D016021:Epidemiologic Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D012865:Skiing / Q000293:injuries*; D013997:Time Factors; D015599:Trauma Severity Indices