In recreational alpine skiing, the ACL is predominantly injured in all knee injuries needing hospitalisation

Knee Surg Sports Traumatol Arthrosc. 2021 Jun;29(6):1790-1796. doi: 10.1007/s00167-020-06221-z. Epub 2020 Aug 14.


Purpose: The knee joint still represents the most frequent anatomical injury location accounting for about one-third of all injuries in recreational alpine skiers. However, comprehensive information on current knee injury patterns in this populations is sparse.

Methods: During the winter seasons 2016/17 and 2019/20, this retrospective questionnaire-based study was conducted in an Austrian sportclinic situated in a large ski area. Among a cohort of 282 recreational skiers (51.8% females), all injuries were diagnosed by the use of magnetic resonance imaging. Additionally, data were recorded on anthropometric characteristics, the perceived speed at the moment of injury, type of fall, physical fitness, self-reported skill level and risk-taking behaviour.

Results: The anterior cruciate ligament (ACL) was injured in all knee injuries recorded. Of the total study sample, 64.5% (n = 182) were ACL injuries with concomitant injuries and about 35.5% (n = 100) were isolated ACL injuries, not involving any other structures of the knee joint. In general, most common concomitant injury diagnoses among ACL-injured recreational alpine skiers were injuries of the medial collateral ligament (MCL) (n = 92, 50.5%), medial meniscus (MM) (n = 73, 40.1%) and lateral collateral ligament (LCL) (n = 41, 22.5%). No significant differences regarding additionally recorded characteristics were found between ACL-injured individuals with concomitant injuries and those with isolated ACL injury.

Conclusions: Whereas, before the introduction of carving skis, the MCL was reported being the most common injured part of the knee, currently, the majority of knee injuries are ACL injuries accompanied by injury of other knee joint structures, i.e. the MCL, MM and LCL.

Level of evidence: Level III.

Keywords: Concomitant injuries; Epidemiology; Knee injury pattern, ACL; Recreational alpine skiing.

MeSH terms

  • Accidental Falls / statistics & numerical data
  • Adult
  • Anterior Cruciate Ligament Injuries / epidemiology*
  • Athletic Injuries / epidemiology*
  • Austria / epidemiology
  • Cohort Studies
  • Collateral Ligaments / injuries
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Knee Injuries / epidemiology*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Retrospective Studies
  • Skiing / injuries*
  • Surveys and Questionnaires