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349 Equipment-related risk factors for ACL injury among recreational skiers – a case control study
  1. Gerhard Ruedl1,
  2. Markus Posch1,2,
  3. Katja Tecklenburg2,
  4. Martin Faulhaber1,
  5. Martin Burtscher1
  1. 1Department of Sport Science, University of Innsbruck, Innsbruck, Austria
  2. 2Medalp sportclinic, Imst, Austria


Background In recreational skiing, an ACL injury is one of the most common diagnosis.

Objective To compare equipment-related risk factors between ACL injured and uninjured skiers.

Design Case-Control study over the 3 winter seasons 2016/17–2018/19 in one major Austrian ski resort.

Participants 248 ACL injured (52% females) and 1054 uninjured skiers (48% females).

Assessment of Risk Factors ACL injury was diagnosed by MRI in a sports clinic located in the ski area. Ski length [m] and side cut radius [m] were taken from the information given on the ski and ski length was relativized to body height [%]. Combined height of ski and binding plate [mm] at the front (HF) and back part (HB) of the ski binding, and height at the toe (HT) and heel piece (HH) of the ski boot [mm] were measured with a digital sliding caliper. Quotients between HF and HB as well as between HT and HH were calculated.

Results ACL injured and uninjured skiers did not differ regarding ski length to height ratio (95.3±4.6 vs. 94.9±3.8%, p=.503) or side cut radius (13.9±2.0 vs. 14.4±2.7m, p=.243). Compared to uninjured skiers, ACL injured skiers had a significantly lower absolute mean HF (40.7±5.7 vs. 38.3±4.8 mm, p <.001, d=0.44) and HB (44.9±6.7 vs. 39.2±5.1 mm p<.001, d=0.82) and a higher quotient HF/HB (0.91±0.08 vs. 0.98 vs, p<.001, d=0.75). Moreover, a lower absolute mean HT (16.8±2.3 vs. 13.8±1.6 mm, p <.001, d=1.19) and HH (26.8±2.6 vs. 24.2±1.9 mm, p <.001, d=0.99) and a lower quotient HT/HH (0.63±0.09 vs. 0.57±0.06, p <.001, d= 0.65) of the ski boots were found in ACL injured skiers.

Conclusions ACL injured and uninjured skiers differed significantly regarding ski boot sole abrasion and combined height of ski and binding plate, which should be considered as potential risk factors for ACL injuries among recreational skiers.

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