Evidence Supporting ACL-Injury-Prevention Exercise Programs: A Review of the Literature

ATHLETIC THERAPY TODAY ATHLETIC THERAPY TODAY MARCH 2006  11 chondral-surface damage, and early onset of osteoarthitis.5-8 It has been reported that individuals suffering acute knee injury, such as ACL injury, are 7.4 times more likely to develop knee osteoarthritis than those with no history of knee injury.9 Ultimately, the disability associated with ACL injury can lead to reduced physical activity levels and loss of independence. In addition to disability, ACL injury places a large financial burden on the health-care system, with health-care costs reported to be as high at $2.5 billion annually.10 The frequency, disability, and excessive cost associated with ACL injury make it a significant health concern. Thus, there is a great need to prevent ACL injuries from occurring. The rate of ACL injury is greater in females than males, especially in younger individuals. Research indicates that females who are involved in recreational, as well as organized physical, activities injure their ACLs at a rate of 2 to 5 times greater than that in males.11-18 Some studies have reported a rate in females over 10 times greater than the male rate, but they are based on small numbers of ACL injuries and should be regarded as tentative.15 The risk of ACL injury is greater in younger individuals (e.g., high school and college age).19 Data on ACL-reconstruction procedures by candidates for the certification of the American Board of Orthopaedic Surgeons suggest that more ACL-reconstruction procedures are performed for high-schooland college-age individuals than any other age group.20 The number of ACL-reconstruction procedures for high-schooland college-age females is 3 DARIN A. PADUA, PhD, ATC, and STEPHEN W. MARSHALL, PhD • University of North Carolina at Chapel Hill