Little is known about the evolution of anterior cruciate ligament injury rates among elite alpine skiers. Purpose: To evaluate epidemiologic aspects of anterior cruciate ligament injuries among competitive alpine skiers during the last 25 years. Study Design: Descriptive epidemiology study. Methods: Data were collected from elite French national teams (379 athletes: 188 women and 191 men) from 1980 to 2005. Results: Fifty-three of the female skiers (28.2%) and 52 of the male skiers (27.2%) sustained at least 1 anterior cruciate ligament injury. The overall anterior cruciate ligament injury incidence was 8.5 per 100 skier-seasons. The primary anterior cruciate ligament injury rate was 5.7 per 100 skier-seasons. The prevalence of reinjury (same knee) was 19%. The prevalence of a bilateral injury (injury of the other knee) was 30.5%. At least 1 additional anterior cruciate ligament surgery (mean, 2.4 procedures) was required for 39% of the injured athletes. Men and women were similar with regard to primary anterior cruciate ligament injury rate (P = .21), career remaining after the injury (P = .44), and skiing specialty (P = .5). There were more anterior cruciate ligament injuries (primary, bilateral, reinjuries) among athletes ranking in the world Top 30 (P < .001). Anterior cruciate ligament-injured athletes had a career length of 7.5 years, whereas athletes with no anterior cruciate ligament injury had a career of 4.5 years (P < .001). Finally, injury rates remained constant over time. Conclusion: Anterior cruciate ligament injury rates (primary injury, bilateral injury, reinjury) among national competitive alpine skiers are high and have not declined in the last 25 years. Finding a way to prevent anterior cruciate ligament injury in this population is a very important goal.
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