ACL injury incidence, severity and patterns in professional male soccer players in a Middle Eastern league

Rekik, R; Tabben, Montassar; Eirale, Christiano; Landreau, Philippe; Bouras, Rachid; Wilson, Mathew G; Gillogly, Scott D.; Bahr, Roald; Chamari, Karim

doi:10.1136/bmjsem-2018-000461

Cited by 23 publications

(29 citation statements)

References 29 publications

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“…ACL injury prevention is especially important in soccer, where many players fear ACL tears [9,[12][13][14], its complications and injury recurrence [15][16][17][18][19]. One of the most important findings of the present study is that ACL-IPP significantly decreases the DKV similarly on both legs during the SLS test performance (62.57% and 53.34%, in dominant and non-dominant leg, respectively).…”

Section: Discussionsupporting

confidence: 56%

“…Res. Public Health 2020, 17, 2 of 13 in soccer becomes even more important, as it seems to be one of the most complex injuries to treat and the one which disables the athlete the longest [12][13][14]. In addition, even after a proper ACL reconstruction and rehabilitation, individuals often have impaired strength, proprioception, stability, balance and neuromuscular control [15], as well as an increased risk for ACL re-injury [16].…”

Section: Introductionmentioning

confidence: 99%

“…The anterior cruciate ligament (ACL) rupture is one of the most severe and prevalent injuries in soccer and ball sports [ 9 ], occurring mostly in noncontact situations [ 10 , 11 ]. Furthermore, ACL rupture in soccer becomes even more important, as it seems to be one of the most complex injuries to treat and the one which disables the athlete the longest [ 12 , 13 , 14 ]. In addition, even after a proper ACL reconstruction and rehabilitation, individuals often have impaired strength, proprioception, stability, balance and neuromuscular control [ 15 ], as well as an increased risk for ACL re-injury [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Acute Effects of ACL Injury-Prevention Warm-Up and Soccer-Specific Fatigue Protocol on Dynamic Knee Valgus in Youth Male Soccer Players

Marco

Cortell-Tormo

García-Jaén

et al. 2020

IJERPH

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Childhood anterior cruciate ligament (ACL) injuries—which can pose a major risk to a child’s sporting career—have been on the rise in the last few decades. Dynamic knee valgus (DKV) has been linked to an increased risk of ACL injury. Therefore, the aim of this study was to analyze the acute effects of an ACL injury prevention protocol (ACL-IPP) and a soccer-specific fatigue protocol (SSFP) on DKV in youth male soccer players. The research hypothesis was that DKV would be reduced by the ACL-IPP and increased by the SSFP. Eighteen youth male soccer players were divided according to baseline DKV. Those with moderate or large DKV performed a neuromuscular training protocol based on activation of the abductor and external rotator hip muscles. Those with little or no DKV performed a soccer-specific fatigue protocol. DKV was assessed using the single-leg squat pre- and post-protocols in both legs. The ACL-IPP significantly decreased DKV during single-leg squat (p < 0.01, effect size = 1.39), while the SSFP significantly increased baseline DKV in the dominant leg during single-leg squat (p = 0.012; effect size = 1.74). In conclusion, the ACL-IPP appears to acutely reduce the DKV in youth male soccer players, and the SSFP seems to acutely increase the DKV in those players who showed a light or no DKV in a non-fatigue situation. By using the SSFP, it may be possible to determine which players would benefit from injury prevention programs due to increased DKV during game scenarios, while hip abductor and external rotator neuromuscular training may be beneficial for players who have moderate and severe DKV during single-leg squat under non-fatigued scenarios.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute Effects of ACL Injury-Prevention Warm-Up and Soccer-Specific Fatigue Protocol on Dynamic Knee Valgus in Youth Male Soccer Players

Marco

Cortell-Tormo

García-Jaén

et al. 2020

IJERPH

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“…Preventive programs are considered important measures to protect a player’s heath and career; however, to optimize the efficacy of these programs, it is important to first define the number of injuries as well as their mechanism, frequency, and severity in an ecologically valid population. 29…”

mentioning

confidence: 99%

“…Only a few reports on ACL epidemiology have been published so far, analyzing different populations and different time periods and utilizing various methodologies to collect injuries. 27,29,31,36 At the present time, the most authoritative data derive from the Union of European Football Associations (UEFA) study by Waldén et al, 36 where an ACL injury incidence of 0.309 per 1000 hours of play and 0.013 per 1000 hours of training was reported. While that study represents a valid and generalizable model depicting the average status of the art of European football because of its heterogeneity, the lack of the systematic focus on a single well-defined league during a limited time span represents a potential limitation for studying relevant factors such as injury distribution across the season or within different teams.…”

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confidence: 99%

Epidemiology of Anterior Cruciate Ligament Injury in Italian First Division Soccer Players

Grassi

Macchiarola

Filippini

et al. 2019

Sports Health: A Multidisciplinary Approach

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Background: The burden of anterior cruciate ligament (ACL) injury in professional soccer players is particularly relevant as it represents a potentially career-threatening injury. Hypothesis: Our hypotheses were that (1) injury incidence rate would be similar to that reported in the literature, (2) we would identify a uniform distribution of the injuries along the season, and (3) injury incidence rate would be similar in high-ranked and lower ranked teams, based on final placement in the league. Study Design: Descriptive epidemiological study. Level of Evidence: Level 4. Methods: Professional male soccer players participating in the Serie A championship league in 7 consecutive seasons (2011-2012 to 2017-2018) were screened to identify ACL injuries through the online football archive transfermarkt.com . Exposure in matches and training were calculated. Results: There were 84 ACL injuries found (mean player age, 25.3 ± 4.2 years). Overall, 25% of ACL injuries were reruptures (15%) or contralateral injuries (10%). ACL incidence rate was 0.4215 per 1000 hours of play during Serie A matches, 0.0305 per 1000 hours of training (rate ratio [RR], 13.8; 95% CI, 8.4-22.7; P < 0.0001), and 0.0618 per 1000 hours of total play. Injury distribution had a bimodal peak, with the highest number of events in October and March. Alternatively, training injuries peaked in June and July. A significantly higher incidence rate was found for the teams ranked from 1st to 4th place compared with those ranked 5th to 20th (0.1256 vs 0.0559 per 1000 hours of play; RR, 2.2; 95% CI, 1.4-3.6; P = 0.0003). A similar finding was found for injury incidence proportion (3.76% vs 1.64%; P = 0.0003). Conclusion: The overall incidence rate of ACL injuries in Italian Serie A was 0.062 per 1000 hours, with a 14-fold risk in matches compared with training. Relevantly, 25% were second injuries. Most injuries occurred in October and March, and an almost 2-fold incidence rate and incidence proportion were noted in those teams ranked in the first 4 positions of the championship league. Clinical Relevance: Knowing the precise epidemiology of ACL injury in one of the most competitive professional football championship leagues could help delineate fields of research aimed to investigate its risk factors.

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High revision arthroscopy rate after ACL reconstruction in men's professional team sports

Bloch

Reinsberger

Klein

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeThe study analysed unique data on anterior cruciate ligament (ACL) injuries among German professional male team sports over five consecutive seasons with the aim of improving medical outcomes in the future. Sport‐specific differences in injury occurrence, concomitant injuries, timing of ACL reconstruction, graft type selection and short‐term complications were examined. MethodsThis retrospective study analysed trauma insurance data on all complete ACL tears from players with at least one competitive match appearance in the two highest divisions of German male basketball, ice hockey, football and handball. Each complete ACL tear registered by clubs or physicians between the 2014/15 and 2018/19 seasons with the German statutory accidental insurance for professional athletes (VBG) as part of occupational accident reporting was included. ResultsIn total, 189 out of 7517 players (2.5%) sustained an ACL injury, mainly in handball (n = 82; 43.4%) and football (n = 72; 38.1%) followed by ice hockey (n = 20; 10.6%) and basketball (n = 15; 7.9%).Seventeen players (9.0%) also sustained a second ACL injury. Thus, 206 ACL injuries were included in the analysis. The overall match incidence of ACL injuries was 0.5 per 1000 h and was highest in handballs (1.1 injuries per 1000 h). A total of 70.4% of ACL injuries involved concomitant injury to other knee structures, and 29.6% were isolated ACL injuries. The highest rate of isolated ACL injuries was seen in ice hockey (42.9%). All ACL injuries, except for one career‐ending injury, required surgery. In the four analysed team sports, hamstring tendons (71.4%) were the most commonly used grafts for ACL reconstruction; football had the highest percentage of alternative grafts (48.7%). During rehabilitation, 22.9% of all surgically treated ACL injuries (n = 205) required at least two surgical interventions, and 15.6% required revision arthroscopy. The main cause of revision arthroscopy (n = 32; 50.0%) was range‐of‐motion deficit due to arthrofibrosis or cyclops formation. ConclusionThe present study shows an overall high rate of revision arthroscopy after ACLR (15.6%), which should encourage surgeons and therapists to evaluate their treatment and rehabilitation strategies in this specific subpopulation. Hamstring tendon grafts are most commonly used for ACL reconstruction but have the highest revision and infection rates. Handball shows the highest ACL injury risk of the four evaluated professional team sports. Concomitant injuries occur in the majority of cases, with the highest share of isolated ACL injuries occurring in ice hockey. Level of evidenceLevel III.

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ACL injury incidence, severity and patterns in professional male soccer players in a Middle Eastern league

Cited by 23 publications

References 29 publications

Acute Effects of ACL Injury-Prevention Warm-Up and Soccer-Specific Fatigue Protocol on Dynamic Knee Valgus in Youth Male Soccer Players

Acute Effects of ACL Injury-Prevention Warm-Up and Soccer-Specific Fatigue Protocol on Dynamic Knee Valgus in Youth Male Soccer Players

Epidemiology of Anterior Cruciate Ligament Injury in Italian First Division Soccer Players

High revision arthroscopy rate after ACL reconstruction in men's professional team sports

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