Evidence map›Paper›PMID 29514822›Full record

SynthesisBritish journal of sports medicine2019

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

Alicia M Montalvo, Daniel K Schneider, Laura Yut, Kate E Webster, Bruce Beynnon, Mininder S Kocher, Gregory D Myer

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of sports medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 112 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 17 pooled it
14.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 17 syntheses or guidelines pooled it, 242 citations in OpenAlex.

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  6. International journal of molecular sciences · 2025
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  8. Outcomes of hamstring graft with preserved tibial insertion for ACL reconstruction: systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024
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52 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Alicia M MontalvoDepartment of Athletic Training, Florida International University, Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA.
Daniel K SchneiderCollege of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
Laura YutDepartment of Biostatistics, Robert Stempel School of Public Health and Social Work, Florida International University, Miami, Florida, USA.
Kate E WebsterSchool of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.
Bruce BeynnonDepartment of Orthopedics and Rehabilitation, University of Vermont College of Medicine, Burlington, Vermont, USA.
Mininder S KocherDepartment of Orthopedic Surgery, Harvard Medical School, Boston, Massachusetts, USA.
Gregory D MyerDivision of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Cincinnati Children's Hospital Medical Center · USFlorida International University · USHarvard University · USLa Trobe University · AUUniversity of Vermont · US

Funding

Prognostic Study of the Risk Factors for Contralateral ACL InjuryR01AR050421 · NIAMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI BEYNNON, BRUCE · 2007 to 2022
$4.7M
Real-Time Sensorimotor Feedback for Injury Prevention Assessed in Virtual RealityU01AR067997 · NIAMS · EMORY UNIVERSITY · PI MYER, GREGORY DONALD · 2016 to 2022
$3.6M
Biomarkers of Cartilage Metabolism and OAR01AR051477 · NIAMS · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI BEYNNON, BRUCE · 2004 to 2008
$1.7M
NIAMS NIH HHS R01 AR050421NIAMS NIH HHS R01 AR051477NIAMS NIH HHS U01 AR067997
6 · The paper itself

Abstract

objectiveTo estimate the incidence proportion (IP) and incidence rate (IR) for ACL injury in athletes.

designSystematic 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.

resultsFifty-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<0.01) and a higher incidence rate ratio (IRR) of ACL injury compared with males over 1 season-25 years (IRR=1.7; 95% CI 1.4 to 2.2; P<0.010). When accounting for participation level, the disparity in the IR between female and male athletes was highest for amateur athletes compared with intermediate and elite athletes (IRR=2.1; 95% CI 1.3 to 3.4; P<0.01; I²=82%). Amateur female athletes remained at higher risk of ACL injury than did with amateur male athletes. In studies where follow-up length was <1 year, female athletes had a higher IR of ACL injury than did to males (IRR=1.7; 95% CI 1.3 to 2.2; P<0.01). Where follow-up was 1 year and beyond, there was no sex difference in the IR of ACL injury (IRR=2.1; 95% CI 0.9 to 4.8; P=0.06; I²=65%). SUMMARY/

conclusionsOne 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.

Indexed as

Anterior Cruciate Ligament InjuriesAthletic InjuriesFemaleHumansIncidenceMaleRisk FactorsSex DistributionSex FactorsACLathleteepidemiologyknee

Identifiers

PMID29514822
PMCPMC6561829
OpenAlexW2792660174

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.