Epidemiology Of Knee Injuries In NCAA Men’s Football: 2009/10 To 2018/19

PURPOSE: To describe the epidemiology of knee injuries in NCAA men’s football across a 10-year period. METHODS: Men’s football exposure and injury data reported to the NCAA Injury Surveillance Program during 2009/10 through 2018/19 were examined. Certified Athletic Trainers at participating institutions contributed data via their Electronic Medical Record systems. Injury incidence (expressed as rates per 1,000 athlete exposures [AEs]) was examined overall and by event type (practice, competition). Distributions of knee injuries were examined by injury mechanism, activity at time of injury, player position, surface type (grass, turf, other), and diagnosis as frequencies (%). Differential injury incidence across explanatory variables of interest was assessed using Injury Rate Ratios (IRRs) and differential distributions were assessed using Injury Proportional Ratios (IPRs); effect estimates with 95% Confidence Intervals (CIs) excluding 1.00 were deemed statistically significant. RESULTS: During the study period, 4,007 injuries in 2,759,363 AEs (Rate = 1.45 per 1,000 AEs) were reported. The overall knee injury rate was higher in competitions (rate = 6.60) than practices (0.84; IRR = 7.90; 95% CI = 7.43, 8.41). Injuries were most prevalently attributed to player contact mechanisms (51%). The most common specific activity associated with injury was blocking (17%). With regards to playing positions, injuries were commonly attributed to offensive (18%) or defensive lineman (17%). Injuries on turf surfaces accounted for a greater proportion of reported injuries than those on grass (IPR = 1.94; 1.85, 2.04). Most knee injuries were diagnosed as strains (41%); medial collateral ligament tears were especially prevalent (24%). CONCLUSIONS: Knee injuries in NCAA men’s football commonly occurred in competitions, on turf, and were resultant of player contact. Over one-third of all reported injuries were among offensive and defensive lineman. Research into injury risk factors in lineman could be useful in reducing knee injuries in NCAA men’s football. Supported by: The NCAA ISP is funded by the NCAA. The Datalys Center is an independent non-profit research center.