Epidemiology of meniscal injuries in US high school athletes between 2007 and 2013

Abstract

Purpose Knowledge of epidemiologic trends of meniscal injuries in young active populations is limited. Better awareness of injury patterns is a first step to lowering injury rates. Our hypothesis was that meniscal injuries in high school athletes would vary by gender, sport, and type of exposure. Methods During 2007–2013, a large nationally disperse sample of US high schools reported athlete exposure and injury data for 22 sports by having certified athletic trainers complete an internet-based data collection tool. Results 1,082 meniscal injuries were reported during 21,088,365 athlete-exposures for an overall injury rate of 5.1 per 100,000 athlete exposures. The overall rate of injury was higher in competition (11.9) than practice (2.7) (RR = 4.4; 95% CI, 3.9–5.0), and 12/19 sports showed significantly higher injury rates in competition compared to practice. Of all injuries, 68.0% occurred in boys, yet among the gender-comparable sports of soccer, basketball, track and field, lacrosse, and baseball/softball injury rates were higher for girls than boys (5.5 and 2.5, respectively, RR = 2.2; 95% CI, 1.8–2.7). Contact injury represented the most common mechanism (55.9%). Surgery was performed for the majority of injuries (63.8%), and 54.0% of athletes had associated intra-articular knee pathology. Conclusions Meniscal injury patterns among high school athletes vary by gender, sport, and type of exposure. Overall rates are higher for boys, but this is driven by football; however in gender-comparable sports girls may be at higher risk for meniscal injury. Our study is clinically relevant because recognition of distinct differences in these injury patterns will help drive evidence-based, targeted injury prevention strategies and efforts. Level of Evidence Level III

Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics

“…The incidence also has been found to be higher in active populations such as military members, in whom the meniscus tear incidence rate was determined to be 8.27 per 1000 person‐years (10 times higher than any documented civilian study) . Acute meniscal tears also occur at higher frequencies during athletic events, reportedly as high as 5.1 per 100 000 athlete exposures in high school‐age athletes .…”

“…The menisci are fibrocartilaginous structures that contribute to static weight bearing, distributing compressive forces during joint movement, joint lubrication, joint stabilization, and proprioception . Meniscal tears are a commonly occurring musculoskeletal injury across all age and functional groups , with incidental radiographic pathologic changes occurring in the asymptomatic population . The mean annual incidence has been estimated to be as high as 60‐70 per 100 000 knee injuries based on previous reviews .…”

Transcriptome Sequencing Reveals Sex Differences in Human Meniscal Cell Response to Estrogen Based on Dosing Kinetics

“…4 Also, tears of the meniscal body are more common in women than in men. 5 Further, recent epidemiological studies have found that meniscal injury rates are higher in female high school athletes than in males competing in comparable sports, 6 and that females require repeat meniscal repair surgeries 2.2x more frequently. 7 These data suggest that sex hormone levels, including estrogen, may play a role in meniscal injury and repair.…”

Clinical practice and post-operative rehabilitation after knee arthroscopy varies according to surgeon's expertise: a survey among Polish Arthroscopy Society members.

“…The menisci injury is a common ailment of the knee injury [1]. Due to its hypovascularity and hypocellularity, a meniscus tear does not heal spontaneously [2,3,4] and prolonged untreated damage may lead to the development of osteoarthritis [5,6,7].…”