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<div style="margin: 0in 0in 0pt">Female soccer and basketball players have the highest rates of ACL injuries</div>
<div style="margin: 0in 0in 0pt">Female soccer players have more non contact ACL injuries than male soccer players</div>
<div style="margin: 0in 0in 0pt">Male and female basketball players have similar rates of contact and non contact ACL injuries</div>
<div style="margin: 0in 0in 0pt">The rates of ACL injuries can be reported as injuries/1000 hrs of exposure or injuries/exposure</div>
<div style="margin: 0in 0in 0pt">NCAA data is reported as injuries/exposure</div>
<div style="margin: 0in 0in 0pt">Athletes have a higher rate of injury and a greater number of injuries during match play as compared to practice or training time.</div>
<div style="margin: 0in 0in 0pt">Many theories for etiology of increased risk for females versus males but poor definitive evidence for one cause</div>
<div style="margin: 0in 0in 0pt">Most likely multifactorial</div>
<div style="margin: 0in 0in 0pt">Theories:&nbsp;</div>
<div style="margin: 0in 0in 0pt 0.5in">extrinsic ((body movement in sport, muscular strength and coordination, shoe-</div>
<div style="margin: 0in 0in 0pt 0.5in">surface interface, and level of skill and conditioning)</div>
<div style="margin: 0in 0in 0pt; text-indent: 0.5in">intrinsic (joint laxity, limb alignment, notch</div>
<div style="margin: 0in 0in 0pt; text-indent: 0.5in">dimensions, and ligament size).</div>
<div style="margin: 0in 0in 0pt">&nbsp;</div>
<div style="margin: 0in 0in 0pt">&nbsp;</div>
<div style="margin: 0in 0in 0pt">Rates of injuries in NCAA have not changed significantly despite awareness and modifications in training techniques over the past 19 years:</div>
<div style="margin: 0in 0in 0pt">&nbsp;</div>
<div style="margin: 0in 0in 0pt">13 year follow up NCAA study from 1990-2002 of male and female soccer and basketball players by Agel et al:</div>
<div style="margin: 0in 0in 0pt">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Results reported as injury/1000 athlete exposures</div>
<div style="margin: 0in 0in 0pt 0.5in">The rate of anterior cruciate ligament injury for male soccer players was 0.11 compared to 0.08 for male basketball players (<em>P </em>= .002).</div>
<div style="margin: 0in 0in 0pt 0.5in">The rate of anterior cruciate ligament injury for female soccer players was 0.33 and for female basketball players was 0.29 (<em>P </em>= .04).</div>
<div style="margin: 0in 0in 0pt 0.5in">No significant difference was seen in basketball comparing frequency of contact versus non contact injuries between men (70.1%) and women (75.7%).</div>
<div style="margin: 0in 0in 0pt 0.5in">In soccer, there was a significant difference in frequency of injury for male (49.6%) and female (58.3%) athletes when comparing contact and non contact injuries ( <em>P </em>&lt; .05)</div>
<div style="margin: 0in 0in 0pt">&nbsp;</div>
<div style="margin: 0in 0in 0pt">4 year sampling study of NCAA in 1989-1993 by Arendt et al:</div>
<div style="margin: 0in 0in 0pt">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Rate per 1000 athlete exposures (a practice or</div>
<div style="margin: 0in 0in 0pt">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; a game is one exposure):</div>
<div style="margin: 0in 0in 0pt; text-indent: 0.5in">Women&rsquo;s soccer .31</div>
<div style="margin: 0in 0in 0pt; text-indent: 0.5in">Men&rsquo;s soccer .13</div>
<div style="margin: 0in 0in 0pt; text-indent: 0.5in">Women&rsquo;s basketball .26</div>
<div style="margin: 0in 0in 0pt; text-indent: 0.5in">Men&rsquo;s basketball .07</div>
<div style="margin: 0in 0in 0pt 0.5in">Women&rsquo;s soccer 60-70% non contact</div>
<div style="margin: 0in 0in 0pt; text-indent: 0.5in">Men&rsquo;s soccer 50% non contact</div>