???What???s my risk of sustaining an ACL injury while playing sports???? A systematic review with meta-analysis

Objective To estimate the incidence proportion (IP) and incidence rate (IR) for ACL injury in athletes. Design Systematic review with meta-analysis Data sources The PubMed, CINAHL and SPORTDiscus electronic databases were searched from inception to 20 January 2017. Eligibility criteria for selecting studies Studies were included if they reported total number of participants/population by sex, total number of ACL injuries by sex and total person-time by sex. Results Fifty-eight studies were included. The IP and IR of ACL injury in female athletes were 3.5% (1 out of every 29 athletes) and 1.5/10 000 athlete-exposures over a period of 1 season-25 years. The IP and IR of ACL injury in male athletes were 2.0% (1 out of every 50 athletes) and 0.9/10 000 athlete-exposures over a period of 1–25 years. Female athletes had a higher relative risk (RR) for ACL injury compared with males (RR=1.5; 95% CI 1.2 to 1.9; P Summary/conclusions One in 29 female athletes and 1 in 50 male athletes ruptured their ACL in a window that spanned from 1season to 25 years. The IR of ACL injury among female athletes in a season was 1.7 times higher than the IR of ACL injury among male athletes and the IP of ACL injury among female athletes was 1.5 times higher than the IP of ACL injury among male athletes. The reported sex disparity in ACL injury rates is independent of participation level and length of follow-up.