Intrinsic and Extrinsic Risk Factors for Anterior Cruciate Ligament Injury in Australian Footballers

Abstract

The aim of this study was to examine the interaction between intrinsic (player-related) and extrinsic (environment-related) variables as risk factors for anterior cruciate ligament injury in Australian football. Between 1992 and 1999, 100,820 player-match exposures were analyzed for risk of anterior cruciate ligament injury using logistic regression analysis. There were 63 surgically proven noncontact anterior cruciate ligament injuries. The strongest risk factors were a player history of anterior cruciate ligament reconstruction either in the previous 12 months (relative risk [RR], 11.33; 95% confidence interval [CI], 4.02 to 31.91) or before the previous 12 months (RR, 4.44; 95% CI, 2.46 to 8.01). Weather conditions that were associated with dry field conditions--high water evaporation in the month before the match (RR, 2.55; 95% CI, 1.44 to 4.52) and low rainfall in the year before the match (RR, 2.87; 95% CI, 1.30 to 6.32)--were also significantly associated with these injuries. The increased risk of injury in the first 12 months after reconstruction was associated with the reconstructed knee, whereas after 12 months there was an even distribution of new injuries to the reconstructed knee and contralateral knee. A history of anterior cruciate ligament reconstruction is a risk factor for further injury. Weather conditions of high evaporation and low rainfall before matches are associated with noncontact anterior cruciate ligament injury.

Effects of a Knee Extension Constraint Brace on Lower Extremity Movements after ACL Reconstruction

“…Although the majority of injured athletes are able to return to preinjury competition levels after rehabilitation, their performances may be adversely affected [7]. In addition, these athletes still have a higher risk of ACL reinjury [10,13,32,33,36,37,40] and of having secondary knee disorders develop, such as osteoarthritis, chronic knee instability, and damage to menisci and chondral surfaces [10,16,24,42]. Enhanced rehabilitation techniques are needed to improve the outcome of the rehabilitation and quality of life of patients after ACL reconstruction.…”

Did the NFL Lockout Expose the Achilles Heel of Competitive Sports?

“…1,7,19 Another consequence of the 2011 NFL Lockout may be an increase in relative reinjury risk during early sports reintegration, due to greater residual biomechanical and neuromuscular deficits from prior injuries or surgeries sustained in previous years. 3,8,18,20 The "release for full activity" is a potentially sensitive landmark for the athlete who has a strong desire to return to immediate high-level sports participation. 12 During standard NFL preseason rehabilitation, the sports medicine team and strength and conditioning staff work together with the athlete to bridge the potential gap between the athletes' perceived versus actual sports readiness.…”

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION & THE HAMSTRINGS Implications for injury prevention & rehabilitation

“…Previous investigations have identified increasing age as a risk factor for HSI in Australian footballers Orchard, Seward, McGivern, & Hood, 2001;Verrall et al, 2001) and soccer players (Arnason et al, 2004;Henderson et al, 2010;Woods et al, 2004). Both elite and sub-elite Australian footballers and soccer players older than 23 to 24 years have been reported to be at an increased risk of HSI than younger players .…”

“…It has been argued that greater shoesurface friction and torsional resistance in dry conditions cause a greater number of ACL injuries (Orchard, 2002;Orchard et al, 2001). It is noteworthy that higher levels of friction between shoe type and playing surface also produce higher levels of sport performance (Malisoux, Gette, Urhausen, Bomfim, & Theisen, 2017).…”

“…In Australia, ACL injuries cost professional sporting organisations an estimated AUD$17 000 -25 000 per athlete for surgery and rehabilitation (Orchard, Seward, McGivern, & Hood, 1999;Orchard et al, 2001), and these injuries are associated with development of early onset osteoarthritis and anterior knee pain later in life (Lohmander et al, 2007). Similarly, HSIs cost sport organisations millions of dollars (Verrall et al, 2006;Woods et al, 2002).…”