April 2014

Cost-effectiveness study favors universal athlete training for ACL injury prevention

In the moment: Sports medicine

By P.K. Daniel

New research supports universal neuromuscular training of all young athletes—not just those at risk—as the most cost-effective and practical way to prevent anterior cruciate ligament (ACL) injuries.

Researchers from Columbia University in New York City used a computer model based on data from recent clinical trials to assess three strategies—no training or screening, universal neuromuscular training, and universal screening with neuromus- cular training for identified high-risk athletes only—in a hypothetical cohort of 10,000 athletes aged 14 to 22 years.

The study found that universal training would reduce the incidence of ACL injury by 63% (from .03 to .011 injuries per player per season), while the screening program would reduce the incidence by 40% (from .03 to .018 per player per season). Implementing universal training, which the researchers estimated would cost $1.25 per player per season, would result in a savings of $275 per player per season compared with no intervention.

The findings were presented in March at the annual meeting of the American Academy of Orthopaedic Surgeons, held in New Orleans.


Swart E, Redler L, Fabricant P, et al. Prevention programs for anterior cruciate ligament injuries: A cost-effectiveness analysis. Presented at the Ameri- can Academy of Orthopaedic Surgeons 2014 Annual Meeting, New Orleans, LA, March 2014.

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