The worrying rise of ACL injuries in Australia

By Damian Cocciolone

The Rise of ACL Injuries In Australia

 There has been a dramatic increase in primary ACL reconstruction surgery in Australia in the 25 and under age range. Zbrojkiewicz et al. (2018) reported a 74% increase in the total number of ACL reconstructions in this population between the years 2000-2015.

Equally concerning is the rise in revision ACL surgery, that is a second ACL reconstruction due to a failed primary surgery, is occurring at a higher rate. 

Putting that simply more young people are injuring their knee’s and having ACL reconstruction surgery and more of them are re-injuring on their way to recovery resulting in a second operation. This raises many questions and has sparked some important debate around ACL reconstructive surgery and the rehabilitation following. 

There is at present debate that exists over the need to have reconstructive surgery following injury to an ACL, particularly given the costs outlined. This is something that should be evaluated on an individual basis between all parties concerned, in an informed decision making process.

ACL Injuries in Children

Children aged 5-14 had the highest rates of increase in Primary reconstruction compared to all other age groups! In these younger age groups the rate of increase was higher in females relative to males. 

There are still far more total ACL reconstructions in the male population (likely due to higher participation rates in change direction sports). However we also know that females are 2-10 times more likely to suffer an ACL injury when participating in high risk sports such as soccer, netball, basketball, touch football and AFL to name a few (Hewett et al, 1999). An increase in the popularity of female change direction sports are contributing to higher participation rates in younger females and subsequently an increase in ACL injuries.

There are several proposed theories as to why ACL injuries are occurring at a younger age as outlined in the table below.

Injury Reduction Programs

Despite these worrying trends it is not all doom and gloom. There is compelling evidence that participation in simple exercise programs that are designed to minimise the risk of lower limb injury do have a dramatic effect on ACL injury rates. A 50% reduction in the risk of all ACL injuries, and a 67% reduction in non-contact ACL injuries in females!

Preventing injury in the first instance is without question an area that should be focussed on. Especially given the strength of evidence that supports prevention programs.

In short if you are playing a high risk sport, participating in an injury prevention program is a must. These programs not only significantly reduce your chance of suffering an ACL injury but help to improve performance.The components of these programs include specific exercises that focus on strength, balance, plyometrics and agility. They have been designed to be progressive in nature to cover the various athletic abilities of all participating. These programs have been designed to be completed as part of a warm-up pre-training, 2-3 times per week and take 20 minutes to complete.

There are freely available programs online that have been developed by some of the high risk sporting bodies in Australia.





If you would like more information on ACL injuries, ACL reconstructive surgery or injury reduction programs please contact us!

Risk Assessment/Screening

Movement Rx can assist you with an individualised injury reduction/performance program. We use our state of the art assessment technology to accurately assess your current level of risk and design programs specific to your needs. A validated combination of orthopaedic assessments, strength testing using advanced dynamometry, movement analysis (jumping/landing/hopping) on force platforms and video analysis of movement patterns. This allows us to identify risk and formulate programs to improve these areas. Don’t wait to be injured to intervene!

We are easily accessible to the people of Redcliffe, Moreton Bay Peninsula and linked to the northern suburbs of Brisbane (Norths Lakes, Mango Hill etc) via Anzac Avenue.