ACL injuries highest in young Australians with five to 14-year-old girls recording sharpest rise

Young Australians have the highest incidence of knee injury with five to 14-year-old girls recording the sharpest rise in anterior cruciate ligament (ACL) injuries, according to a new ACU study of 20-year knee injury trends.

Lead author Nirav Maniar, from ACU’s Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, led the study which analysed 228,344 knee injuries diagnosed in private and public Australian hospitals over a 20-year period.

Published in leading medical journal The Lancet Regional Health Western Pacific, the study showed marked annual increases in ACL injuries, knee contusions and, in women, posterior cruciate ligament (PCL) injuries and knee dislocations.

“Of the knee injuries examined, the annual incidence of ACL injuries appears to be increasing most rapidly,” Dr Maniar said.

“Increasing rates of ACL injury are particularly alarming, as the injury is associated with substantial financial burden owing to its common treatment via surgical intervention and a relatively long rehabilitation period.”

Whilst the study found that young Australians, aged 15-29, had the highest incidence of ACL injuries, young girls, aged 5-14, showed the steepest rise in ACL injuries over the 20-year period.

“We have seen more young girls participating in high-risk sporting activities which likely explains the high injury rates we are seeing in this age group,” Dr Maniar said.

“There are also more pathways for girls at the grassroots and elite level to take part in sport but such a steep rise in annual knee injuries in children is concerning.”

Dr Maniar said implementing programs to prevent ACL injuries was critical to improving long-term health outcomes.

Research has shown that a woman who has had an ACL injury can be up to six times more likely to develop osteoarthritis.

“We estimate that ACL injuries will more than double in the next 10 years, reaching an incidence of 77.2 per 100,000 population if current trends continue and no action is taken to reduce the incidence of injury.

“The steep rise in annual knee injuries in children is especially urgent to prevent an impending public health issue, due to established associations of ACL and knee cartilage injuries with knee osteoarthritis.”

He has called for embedded knee injury prevention strategies in national and international public health policies which promote sports and physical activity participation for women.

Previous research has shown injury prevention programs can reduce the incidence of ACL injuries by 53% and knee injuries by 37%. 

Dr Maniar said such programs could be incorporated as part of the general warm up routine prior to sports participation.


Dr Maniar is available for interview.

Media Contact: Elisabeth Tarica, Australian Catholic University on 0418 756 941 or


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