运动时前交叉韧带损伤的风险有多大？系统评价与荟萃分析。
"What's my risk of sustaining an ACL injury while playing sports?" A systematic review with meta-analysis.
机构信息
Department of Athletic Training, Florida International University, Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA.
College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
出版信息
Br J Sports Med. 2019 Aug;53(16):1003-1012. doi: 10.1136/bjsports-2016-096274. Epub 2018 Mar 7.
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<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/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.
目的
估计 ACL 损伤在运动员中的发生率比例（IP）和发生率（IR）。
设计
系统评价与荟萃分析
数据来源
从建库到 2017 年 1 月 20 日，检索 PubMed、CINAHL 和 SPORTDiscus 电子数据库。
入选研究的标准
如果研究报告了按性别划分的总参与者/人群数量、按性别划分的 ACL 损伤总数和按性别划分的总人数-时间。
结果
共纳入 58 项研究。女性运动员 ACL 损伤的 IP 和 IR 分别为 3.5%（每 29 名运动员中就有 1 名）和 1.5/10000 名运动员-暴露于 1 个赛季-25 年。男性运动员 ACL 损伤的 IP 和 IR 分别为 2.0%（每 50 名运动员中就有 1 名）和 0.9/10000 名运动员-暴露于 1-25 年。与男性相比，女性运动员 ACL 损伤的相对风险（RR）更高（RR=1.5；95%置信区间 1.2 至 1.9；P<0.01），在 1 个赛季-25 年期间，女性运动员 ACL 损伤的发病率比男性更高（RR=1.7；95%置信区间 1.4 至 2.2；P<0.010）。在考虑参与水平后，与精英和中级运动员相比，业余运动员中女性和男性运动员之间 ACL 损伤发生率的差异最大（IRR=2.1；95%置信区间 1.3 至 3.4；P<0.01；I²=82%）。与业余男性运动员相比，业余女性运动员仍然面临更高的 ACL 损伤风险。在随访时间<1 年的研究中，女性运动员的 ACL 损伤发生率高于男性（IRR=1.7；95%置信区间 1.3 至 2.2；P<0.01）。在随访时间为 1 年及以上的研究中，男女运动员 ACL 损伤的发生率没有性别差异（IRR=2.1；95%置信区间 0.9 至 4.8；P=0.06；I²=65%）。
总结/结论：每 29 名女性运动员中就有 1 人，每 50 名男性运动员中就有 1 人在 1 个赛季到 25 年的时间内 ACL 断裂。女性运动员 ACL 损伤的发生率是男性运动员的 1.7 倍，女性运动员 ACL 损伤的发生率比例是男性运动员的 1.5 倍。报告的 ACL 损伤发生率的性别差异与参与水平和随访时间无关。
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