Valley Consortium for Medical Education Orthopedic Surgery Residency, Modesto, CA, USA.
Department of Orthopedic Surgery, San Joaquin General Hospital, French Camp, CA, USA.
Phys Sportsmed. 2024 Feb;52(1):98-101. doi: 10.1080/00913847.2023.2178817. Epub 2023 Feb 16.
Anterior cruciate ligament (ACL) injuries are devastating injuries for athletes. Prior studies have shown increased ACL injury rates on non-natural surfaces versus natural grass in several sports. The purpose of this study is to calculate the prevalence of ACL injuries in the NFL on natural versus non-natural surfaces to determine if there is a significant increase on non-natural surfaces.
Accessing publicly available data for NFL seasons beginning with the 2017-2018 season through 2021-2022 seasons, all ACL injuries with publicly available data concerning timing and playing surface were recorded and categorized according to playing surface. Practice injuries or those without an identifiable playing surface were excluded. Incidence rates, defined as ACL ruptures per game, were calculated. ACL injuries were recorded for each playing surface, as well as the combined category of non-natural grass surface. Odds ratio was calculated to compare the risk of ACL rupture on non-natural surfaces vs natural grass.
During the 2017-2021 NFL seasons, 173 ACL ruptures were identified with known surfaces. Injury rate for non-natural surfaces was 0.134 compared to 0.097 for grass. Injury rate ratio for non-natural vs natural grass surfaces was 1.211, a 21.1% increased risk of ACL injury in the NFL on non-natural surfaces vs natural grass. OR for non-natural surfaces 1.239 (95% CI 0.900-1.704). Based on these findings there is a trend toward increased risk of ACL injury on non natural grass surfaces, however this did not reach statistical significance.
Numerous published studies show trends toward increasing rates of ACL injuries on non-natural playing surfaces vs natural grass. Based on our findings the difference is not statistically significant, however it does trend toward increased risk of ACL injury with non-natural surfaces. Further studies should be performed with larger sample sizes in order to further determine the risk of non-natural surfaces.
前交叉韧带（ACL）损伤对运动员来说是毁灭性的损伤。先前的研究表明，在几项运动中，非天然表面的 ACL 损伤发生率高于天然草皮。本研究的目的是计算 NFL 中 ACL 损伤在天然和非天然表面的发生率，以确定非天然表面是否存在明显的增加。
从 2017-2018 赛季到 2021-2022 赛季，获取可公开获得的 NFL 赛季数据，记录并根据比赛场地对所有可公开获得有关时间和比赛场地数据的 ACL 损伤进行分类。排除练习损伤或无可识别比赛场地的损伤。计算发病率，定义为每场比赛的 ACL 破裂数。记录每种比赛场地以及非天然草皮综合类别的 ACL 损伤。计算比值比以比较非天然表面与天然草皮 ACL 破裂的风险。
在 2017-2021 年 NFL 赛季期间，确定了 173 例已知表面的 ACL 破裂。非天然表面的损伤率为 0.134，而草皮的损伤率为 0.097。非天然与天然草皮表面的损伤率比为 1.211，即 NFL 中 ACL 损伤的风险增加了 21.1%。非天然表面的比值比为 1.239（95%CI 0.900-1.704）。基于这些发现，非天然草皮表面 ACL 损伤的风险呈上升趋势，但未达到统计学意义。
许多已发表的研究表明，非天然比赛表面的 ACL 损伤发生率呈上升趋势，而非天然草皮。基于我们的发现，差异没有统计学意义，但确实存在非天然表面 ACL 损伤风险增加的趋势。应进行进一步的研究，以更大的样本量进一步确定非天然表面的风险。
