One of the fastest growing team sports in America, particularly on college
campuses, is women's soccer. Of the more than 17 million players participating
in organized soccer nationwide, 7 million are female. While offering an equal
opportunity playing field for student athletes, soccer has one unfortunate
gender bias: women are more susceptible to knee injury.
One of the most common is tearing of the anterior cruciate ligament
(ACL)--the ligament in the center of the knee that provides stability. In
Sweden, where soccer is wildly popular and women have a shot at playing in a
professional league, the risk of ACL injury is 3 to 4 times higher per game hour
for young female players than for their male counterparts.
As too many soccer players know, tearing this pivotal ligament brings
immediate pain and swelling, followed by a nagging fear of the knee suddenly
giving-way. A recent study, published in the October 2004 issue of Arthritis & Rheumatism, provides compelling evidence of
serious risk of knee osteoarthritis (OA) and potentially crippling long-term
consequences of a torn ACL for young female athletes. Conducted by a team of
researchers at Lund University
Hospital, and supported, in part, by the Swedish Soccer Federation, this
study focused on 103 female soccer players, between the ages of 26 and 40, who
had each suffered an ACL injury 12 years earlier, when they were between the
ages of 14 and 28.
Each woman consented to knee radiographs, as well as answered questionnaires
about her knee-related quality of life. More than half of the women were
assessed as having OA of the knee, accompanied by persistent pain and functional
limitations. What's more, 60 percent of the players had undergone reconstructive
surgery of the torn ligament soon after sustaining their injury. Using various
analyses, the researchers found that surgical reconstruction had no significant
effect on knee pain or disabling symptoms. The surgical techniques used today
for this injury might be more effective in preventing OA, but this has not yet
been proven in scientific studies.
The study's leading researcher, L. S. Lohmander, M.D., Ph.D., describes the
very high prevalence of pronounced OA among these young ACL-injured women as
"alarming," with serious implications for their future. "For many of these
women, the OA disease process can be expected to progress over time and the need
for an osteotomy or knee arthroplasty may arise well before the age of 50 years
in many of these subjects," Dr. Lohmander speculates. "Although joint
replacement may be an efficient treatment for knee OA, the risk of aseptic
implant loosening and revision is more than 3-fold higher in the patients
operated on while younger than age 65 years, than if older than 75 years."
The first long-term study of the risk and complications of OA linked to this
common and serious knee injury specifically among women soccer players, its
findings emphasize the need for improved efforts at prevention and treatment of
this torn ligament. "Randomized, controlled trials are needed in which different
surgical techniques and rehabilitation protocols are compared directly with the
best nonsurgical treatment," Dr. Lohmander concludes.
