Simon Gianotti

Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study.

There has been an intensive research effort directed at determining the cause of non-contact anterior cruciate ligament (ACL) injury over the past decade, but few studies have reported data on the incidence of ACL and other knee ligament injury in the general population. New Zealands no-fault injury compensation data provides a national injury resource of data on claims for knee ligament injury. The goal of this paper was to provide a descriptive epidemiology of knee ligament injury in this country. Data were obtained for knee ligament injuries between 1 July 2000 and 30 June 2005. Injuries were categorised as non-surgical (NS), ACL surgeries (ACLS) and other knee ligament surgeries (OKLS). Incidence rates per 100,000 person-years were computed using population estimates. Costs and number of treatment/rehabilitation visits were obtained as an indication of severity. The incidence rate per 100,000 person-years was 1147.1 for NS, 36.9 for ACLS and 9.1 for OKLS. Males had a higher incidence rate than females for NS, ACLS, and OKLS. The mean (and median) number of treatment visits were NS: 6.6 (4), ACLS: 27.1 (24), and OKLS: 31.3 (24). The mean (median) treatment costs of these injuries were NS

Effect of nationwide injury prevention programme on serious spinal injuries in New Zealand rugby union: ecological study

885 (

Evaluation of RugbySmart: A rugby union community injury prevention programme

129), ACLS

An evaluation of mouthguard requirements and dental injuries in New Zealand rugby union

11,157 (

Efficacy of injury prevention related coach education within netball and soccer

8574), and OKLS

Interim evaluation of the effect of a new scrum law on neck and back injuries in rugby union

15,663 (

A Retrospective Review Over 1999 to 2007 of Head, Shoulder and Knee Soft Tissue and Fracture Dislocation Injuries and Associated Costs for Rugby League in New Zealand

8054). Analysis of injury descriptions for ACLS injuries indicated that 58% involved a non-contact mechanism of injury. These data underscore the high level of short-term disability associated with knee ligament injuries, especially ACL injuries that require surgery.

Neck back and spine injuries in amateur rugby league: A review of nine years of Accident Compensation Corporation injury entitlement claims and costs

Objective To investigate the effect of RugbySmart, a nationwide educational injury prevention programme, on the frequency of spinal cord injuries. Design Ecological study. Setting New Zealand rugby union. Participants Population at risk of injury comprised all New Zealand rugby union players. Intervention From 2001, all New Zealand rugby coaches and referees have been required to complete RugbySmart, which focuses on educating rugby participants about physical conditioning, injury management, and safe techniques in the contact phases of rugby. Main outcome measures Numbers of all spinal injuries due to participation in rugby union resulting in permanent disablement in 1976-2005, grouped into five year periods; observed compared with predicted number of spinal injuries in 2001-5. Results Eight spinal injuries occurred in 2001-5, whereas the predicted number was 18.9 (relative rate=0.46, 95% confidence interval 0.19 to 1.14). Only one spinal injury resulted from scrums over the period; the predicted number was 9.0 (relative rate=0.11, 0.02 to 0.74). Corresponding observed and predicted rates for spinal injuries resulting from other phases of play (tackle, ruck, and maul) were 7 and 9.0 (relative rate=0.83, 0.29 to 2.36). Conclusions The introduction of the RugbySmart programme coincided with a reduction in the rate of disabling spinal injuries arising from scrums in rugby union. This study exemplifies the benefit of educational initiatives in injury prevention and the need for comprehensive injury surveillance systems for evaluating injury prevention initiatives in sport.

Concussion sideline management intervention for rugby union leads to reduced concussion claims

RugbySmart, a rugby union injury prevention programme, was launched in New Zealand in 2001. It was compulsory for all coaches and referees to complete RugbySmart requirements annually in order to continue coaching or refereeing. After 5 years of implementation the programme partners, Accident Compensation Corporation and New Zealand Rugby Union, evaluated RugbySmart to determine its effectiveness in reducing injuries. The purpose was to evaluate the effect of RugbySmart on reducing injury rates per 100,000 players and resulting injury prevention behaviours. The RugbySmart programme was associated with a decrease in injury claims per 100,000 players in most areas the programme targeted; the programme had negligible impact on non-targeted injury sites. The decrease in injury claims numbers was supported by results from the player behaviour surveys pre- and post-RugbySmart. There was an increase in safe behaviour in the contact situations of tackle, scrum and ruck technique.

A cost-outcome approach to pre and post-implementation of national sports injury prevention programmes

Objectives: To document the effects of compulsory mouthguard wearing on rugby related dental injury claims made to ACC, the administrator of New Zealand’s accident compensation scheme. Methods: An ecological study was conducted. Estimates of mouthguard wearing rates were available from prospective studies conducted in 1993, 2002, and 2003. Rugby related dental injury claims were available for the period 1995–2003. Player numbers were available from 1998. Mouthguard wearing was made compulsory during match play for rugby players at under 19 level and below at the beginning of the 1997 season, and for all grades of domestic rugby at the beginning of the 1998 season. Greater powers of enforcement were provided to referees at the beginning of the 2003 season. Results: The self reported rate of mouthguard use was 67% of player-weeks in 1993 and 93% in 2003. A total of 2644 claims was reported in 1995. There was a 43% (90% confidence interval 39% to 46%) reduction in dental claims from 1995 to 2003. On the reasonable assumption that the number of players and player-matches remained constant throughout the study period, the relative rate of injury claims for non-wearers versus wearers was 4.6 (90% confidence interval 3.8 to 5.6). The cumulative savings in claim costs compared with the cost per year if claim numbers had remained constant from 1995 is