scholarly journals Poor Validity of Functional Performance Tests to Predict Knee Injury in Female Soccer Players With or Without Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652110025
Author(s):  
Anne Fältström ◽  
Martin Hägglund ◽  
Henrik Hedevik ◽  
Joanna Kvist
Keyword(s):  
Acl Reconstruction ◽  
Predictive Validity ◽  
Knee Injury ◽  
Functional Performance ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Acl Injury ◽  
Soccer Players ◽  
Performance Tests ◽  
Anterior Cruciate

Background: Various tests have been developed to evaluate athletes’ functional performance and for use as screening tools for injury prediction. Further validation of their accuracy to predict injury is needed. Purpose: To investigate the validity of predetermined cutoffs used to differentiate between high- and low-risk players in different functional performance tests to predict (1) anterior cruciate ligament (ACL) injury or (2) severe traumatic knee injury in a cohort of female soccer players with a primary unilateral ACL reconstruction and a cohort of knee-healthy players. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 117 active female soccer players (mean age ± SD, 20 ± 2 years) an average of 19 ± 9 months after ACL reconstruction and 119 knee-healthy players (age, 19 ± 3 years) were prospectively followed up for 2 years for new knee injuries. At baseline, all players underwent tests to assess postural control (Star Excursion Balance Test), hop performance (single-leg hop for distance, side hop), and movement asymmetries in the lower limbs and trunk (drop vertical jump [DVJ], tuck jump). The predictive validity of the test cutoffs to identify players who would sustain an ACL injury or a severe traumatic knee injury (absence from soccer play, >28 days) was assessed. The risk ratio (RR), area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated. Results: A total of 46 players (39%) with ACL reconstruction sustained 48 severe knee injuries, including 28 ACL ruptures. Of the knee-healthy players, 13 (11%) sustained 14 severe knee injuries, including 8 ACL ruptures. No association was found between the predetermined functional performance test cutoffs and the risk of a new ACL injury or severe knee injury in players with ACL reconstruction. In knee-healthy players, the only variable associated with future ACL injury was ≥6.5 cm knee valgus in the frontal plane (any knee) in the DVJ (RR, 4.93; 95% CI, 1.04-23.40; P = .045), but with only fair predictive validity (AUC, 0.7; sensitivity, 0.75; specificity, 0.65). Conclusion: In our cohorts of female soccer players, the validity of commonly used functional performance tests to predict new knee injuries was poor. Only knee valgus during the DVJ was associated with new ACL injuries in knee-healthy players, but with only fair predictive validity.

scholarly journals High Risk of New Knee Injuries in Female Soccer Players After Primary Anterior Cruciate Ligament Reconstruction at 5- to 10-Year Follow-up

2021 ◽  
pp. 036354652110444
Author(s):  
Anne Fältström ◽  
Joanna Kvist ◽  
Martin Hägglund
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Risk Ratio ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Acl Injury ◽  
Soccer Players ◽  
Healthy Controls ◽  
Anterior Cruciate

Background: A new anterior cruciate ligament (ACL) injury after ACL reconstruction is a feared outcome. Purpose: To study the risk of new knee injuries in female soccer players 5 to 10 years after primary unilateral ACL reconstruction and to compare players who returned to soccer with (1) players who did not return and (2) knee-healthy soccer players (controls). Study Design: Cohort study; Level of evidence, 2. Methods: Demographic, soccer-specific, and surgical data were recorded at baseline for 317 female soccer players (mean ± SD age, 20.1 ± 2.7 years) 1.6 ± 0.7 years after ACL reconstruction and for 119 matched controls (mean age, 19.5 ± 2.5 years). Data on new knee injuries and soccer-playing status were collected 5 to 10 years after ACL reconstruction via a questionnaire. Results: Among players with ACL reconstruction, 222 (70%) responded at a mean 6.5 ± 1.0 years after primary ACL reconstruction. We compared 3 cohorts: (1) among 163 players with ACL reconstruction who returned to soccer, 68 (42%) sustained 44 reruptures and 29 contralateral ruptures; (2) among 59 players with ACL reconstruction who did not return to soccer, 11 (19%) sustained 9 reruptures and 2 contralateral ruptures; and (3) among 113 knee-healthy controls, 12 (11%) sustained 13 ACL injuries. Players who returned had a >2-fold higher risk of a new ACL injury than players who did not return (risk ratio, 2.24; 95% CI, 1.27-3.93; P = .005) and a 4-fold higher risk than controls (risk ratio, 3.93; 95% CI, 2.23-6.91; P <.001). A new ACL, meniscal, or cartilage injury was the most frequent new knee injury. Among players who returned to soccer, 68% reported a new knee injury, and they had a 2- to 5-times higher risk of any new knee injury and knee surgery than players who did not return and controls. Conclusion: Two-thirds of female soccer players with ACL reconstruction who returned to soccer sustained a new knee injury within 5 to 10 years; 42% had a new ACL injury. Their risk of a new knee injury and knee surgery was 2 to 5 times greater than that for players who did not return and for knee-healthy controls. New injury may have negative consequences for long-term knee health and should be a critical consideration in the decision to return to play.

scholarly journals The Effect of Quality of Movement on the Single Hop Test in Soccer Players Aged 15-16 Years

2010 ◽  
Author(s):  
James Roush ◽  
Katherine DoVico ◽  
Sheryl Fairchild ◽  
Kimberly McGriff ◽  
R. Bay
Keyword(s):  
Functional Performance ◽  
Sports Injuries ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Modern Society ◽  
Acl Injury ◽  
Hop Test ◽  
Step Down ◽  
Anterior Cruciate ◽  
The Right

Sports injuries are one of the most common injuries in modern society. The anterior cruciate ligament (ACL) is commonly injured in sports. Soccer is one of many sports where an ACL injury is likely to occur, due to inherent jumping and pivoting during participation. Abnormal movement patterns have been suggested as a risk factor for knee injuries, which lead to the development of the step-down test. The Single Leg Hop for Distance test is used to assess functional performance in individuals with an ACL injury or reconstruction. The purpose of the current study was to determine if there are differences in hop test distances according to scores on the step-down test. A second purpose is to determine the relationship between hop test distances and height. Sixty-one males and sixty-one females between 15 and 16 years who participated in a club soccer program participated in the study. The Hop test and the step-down test were administered to the subjects. Mean hop distance for males was 172.89 cm (SD = 18.27) and the mean hop distance for females was 146.88 cm (SD = 14.63). For both males and females, there were no differences in hop distances between the left and right lower extremity (LE). There were no differences in hop distances according to classification of the step-down test for males. Females classified as good by the step-down test hopped farther than females classified as poor. There were no relationships between distances in the hop test and height in females (r = .23 for the left LE; .21 for the right LE). There was a low relationship between distances in the hop test and height in males (r = .46 for the left LE; .39 for the right LE). Clinicians may utilize this information for goal setting and objective testing during rehabilitation.

scholarly journals An Ecological Study of Anterior Cruciate Ligament Reconstruction, Part 2

2017 ◽  
Vol 5 (2) ◽  
pp. 232596711668844 ◽  
Author(s):  
Timothy M. McGrath ◽  
Gordon Waddington ◽  
Jennie M. Scarvell ◽  
Nick Ball ◽  
Rob Creer ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Performance Test ◽  
Functional Performance ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Performance Tests ◽  
Time To Peak ◽  
Step Down ◽  
Anterior Cruciate ◽  
Peak Speed

Background: Additional high-quality prospective studies are needed to better define the objective criteria used in relation to return-to-sport decisions after anterior cruciate ligament (ACL) reconstruction in active populations. Purpose: To investigate prospectively the relationship between functional performance test results at 24 weeks postoperative and return-to-sport activity (Tegner activity score) at 12 and 24 months, respectively, after synthetic (ligament advanced reinforcement system [LARS]) and autograft (doubled semitendinosus/gracilis [2ST/2GR]) ACL reconstructions. Study Design: Case series; Level of evidence, 4. Methods: A total of 64 patients who underwent ACL reconstruction (32 LARS, 32 2ST/2GR autograft; mean age, 27.9 years; body mass index [BMI], 24.9 kg/m2) were assessed preoperatively and at staged intervals postoperatively up to 24 weeks for isokinetic testing of quadriceps and hamstring average power per repetition at 60 deg/s and 180 deg/s, a battery of hop tests, peak vertical ground-reaction force (vGRF), and time to peak vGRF (in seconds) during a step- and jump-down task onto a force platform and peak speed (m/s) using a global positioning system (GPS unit) during a running task. A cohort of 32 healthy matched participants (mean age, 26.31 years; BMI, 25.7 kg/m2) were also tested to act as reference. Pearson correlation was calculated to assess correlation of each performance measure at 24 weeks postoperative with activity outcomes (Tegner score) at 12 and 24 months. Results: The strongest correlation between physical performance tests and return-to-sport outcomes was observed with peak speed during running. Large correlations were also observed for hamstring isokinetic power and hop test for distance. Moderate correlations were observed for timed hop, peak vGRF during a jump-down task, and quadriceps isokinetic power. No statistical correlations were observed for time to peak vGRF during a step-down and jump-down task as well as peak vGRF during a step-down task. When the performance tests were pooled together, mean postoperative improvements of 24% were observed from preoperative to 24 weeks within the surgical cohort. For each performance test, preoperative level of function strongly correlated with performance levels on the same test at 24 weeks. Discussion: The results of this study indicate that clinicians might seek to prioritize these tests and the rehabilitation themes they imply when seeking to maximize postoperative ACL activity outcomes. The observed strength between pre- and postoperative performance tests and return-to-sport outcomes within this study highlights the potential value of preoperative conditioning before undergoing ACL reconstruction. Future research should examine absolute predictive criterion thresholds for functional performance-based tests and reinjury risk reduction after ACL reconstruction.

scholarly journals Clinical Risk Profile for a Second Anterior Cruciate Ligament Injury in Female Soccer Players After Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652199910
Author(s):  
Anne Fältström ◽  
Joanna Kvist ◽  
Natalia F.N. Bittencourt ◽  
Luciana D. Mendonça ◽  
Martin Hägglund
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Acl Injury ◽  
Soccer Players ◽  
Factors Associated ◽  
Cart Analysis ◽  
Jump Test ◽  
Anterior Cruciate

Background: The risk of a second anterior cruciate ligament (ACL) injury when participating in pivoting sports after ACL reconstruction is high. Risk factors associated with a second ACL injury are complex. Purpose: To investigate the combinations of various clinical risk factors associated with second ACL injury in female soccer players with a primary unilateral ACL reconstruction, using Classification and Regression Tree (CART) analysis. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 117 active female soccer players (mean ± SD age, 20 ± 2 years) were included. Athletes were enrolled 19 ± 9 months after ACL reconstruction and were prospectively followed for 2 years. At baseline, all players underwent assessment of knee and ankle joint range of motion (ROM), participated in functional tests (postural control, hop performance, and movement asymmetries in the lower limbs and trunk), and answered questionnaires (patient-reported knee function, knee-related quality of life, psychological and personality factors). A clinical prediction model using CART was developed. Results: A total of 28 players (24%) sustained a second ACL injury (21 ipsilateral and 7 contralateral ruptures) while playing soccer. CART analysis selected 9 of 19 independent variables associated with second ACL injury: the 5-jump test, knee collapse on the non–ACL reconstructed leg in a drop vertical jump, tuck jump, limb symmetry index on side hop and the single hop for distance, side difference in ankle dorsiflexion ROM, and scores for the questionnaires ACL-Return to Sport After Injury and the Swedish Universities Scales of Personality subscales of Stress Susceptibility and Adventure Seeking. The accuracy of the model was 89%, with 100% sensitivity and 76% specificity. CART analysis indicated that the interaction of longer jumps in the 5-jump test (>916 cm) with more side difference in ankle dorsiflexion ROM (>–2.5°) and more knee valgus collapse in the nonreconstructed knee (>−1.4 cm) (relative risk, 4.03; 95% CI, 2.21-7.36) best predicted an increased likelihood of a second ACL injury. Conclusion: The risk profiles selected by CART could accurately identify female soccer players at high risk for a second ACL injury. There was an interaction between functional performance, clinical assessment, and psychological factors, and it is reasonable to include these factors in return-to-sport decisions and in athlete screening after ACL injury.

scholarly journals Female Soccer Players With Anterior Cruciate Ligament Reconstruction Have a Higher Risk of New Knee Injuries and Quit Soccer to a Higher Degree Than Knee-Healthy Controls

2018 ◽  
Vol 47 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Anne Fältström ◽  
Joanna Kvist ◽  
Håkan Gauffin ◽  
Martin Hägglund
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Activity Level ◽  
Soccer Players ◽  
Healthy Controls ◽  
Acl Injuries ◽  
Activity Scale ◽  
Anterior Cruciate ◽  
Tegner Activity Scale

Background: Many patients with anterior cruciate ligament (ACL) reconstruction who return to sport suffer new ACL injuries or quit sports soon after returning. Purpose: To prospectively follow a cohort of female soccer players with primary unilateral ACL reconstruction and matched knee-healthy controls from the same soccer teams to compare (1) the rate of new traumatic and nontraumatic knee injuries and other injuries, (2) the proportion of players who quit soccer, and (3) player-reported activity level and satisfaction with activity level and knee function. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 117 active female soccer players (mean ± SD age, 19.9 ± 2.5 years) 18.9 ± 8.7 months after ACL reconstruction and 119 knee-healthy female soccer players (19.5 ± 2.5 years) matched from the same teams were prospectively followed for 2 years for new knee injuries, other injuries, soccer playing level, activity level according to the Tegner Activity Scale, and satisfaction with activity level and knee function. Results: Players with ACL reconstruction had a higher rate of new ACL injuries (n = 29 vs 8; 19 vs 4 per 100 player years; rate ratio [RR], 4.82; 95% CI, 2.20-10.54; P < .001), other traumatic knee injuries (29 vs 16 per 100 player years; RR, 1.84; 95% CI, 1.16-2.93; P < .01), and nontraumatic knee injuries (33 vs 9 per 100 player years; RR, 3.62; 95% CI, 2.11-6.21; P < .001) as compared with controls. There was no difference in the rate of other (not knee) injuries (43 vs 48 per 100 player years; RR, 0.90; 95% CI, 0.65-1.23; P = .494). During the 2-year follow-up, 72 (62%) players with ACL reconstruction quit soccer, as opposed to 43 (36%) controls ( P = .001). The median Tegner Activity Scale score decreased in both groups ( P < .001) but more for the ACL-reconstructed group ( P < .015). Conclusion: Female soccer players with ACL reconstruction had nearly a 5-fold-higher rate of new ACL injuries and a 2- to 4-fold-higher rate of other new knee injuries, quit soccer to a higher degree, and reduced their activity level to a greater extent as compared with knee-healthy controls.

scholarly journals Quadriceps Activation Following Knee Injuries: A Systematic Review

2010 ◽  
Vol 45 (1) ◽  
pp. 87-97 ◽  
Author(s):  
Joseph M. Hart ◽  
Brian Pietrosimone ◽  
Jay Hertel ◽  
Christopher D. Ingersoll
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Injury ◽  
Data Extraction ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Quadriceps Muscle ◽  
Control Group ◽  
Data Sets ◽  
Weighted Mean ◽  
Anterior Cruciate

Abstract Context: Arthrogenic muscle inhibition is an important underlying factor in persistent quadriceps muscle weakness after knee injury or surgery. Objective: To determine the magnitude and prevalence of volitional quadriceps activation deficits after knee injury. Data Sources: Web of Science database. Study Selection: Eligible studies involved human participants and measured quadriceps activation using either twitch interpolation or burst superimposition on patients with knee injuries or surgeries such as anterior cruciate ligament deficiency (ACLd), anterior cruciate ligament reconstruction (ACLr), and anterior knee pain (AKP). Data Extraction: Means, measures of variability, and prevalence of quadriceps activation (QA) failure (&lt;95%) were recorded for experiments involving ACLd (10), ACLr (5), and AKP (3). Data Synthesis: A total of 21 data sets from 18 studies were initially identified. Data from 3 studies (1 paper reporting data for both ACLd and ACLr, 1 on AKP, and the postarthroscopy paper) were excluded from the primary analyses because only graphical data were reported. Of the remaining 17 data sets (from 15 studies), weighted mean QA in 352 ACLd patients was 87.3% on the involved side, 89.1% on the uninvolved side, and 91% in control participants. The QA failure prevalence ranged from 0% to 100%. Weighted mean QA in 99 total ACLr patients was 89.2% on the involved side, 84% on the uninvolved side, and 98.5% for the control group, with prevalence ranging from 0% to 71%. Thirty-eight patients with AKP averaged 78.6% on the involved side and 77.7% on the contralateral side. Bilateral QA failure was commonly reported in patients. Conclusions: Quadriceps activation failure is common in patients with ACLd, ACLr, and AKP and is often observed bilaterally.

Ten-Year Risk Factors for Inferior Knee Injury and Osteoarthritis Outcome Score After Anterior Cruciate Ligament Reconstruction: A Study of 874 Patients From the Swedish National Knee Ligament Register

2018 ◽  
Vol 46 (12) ◽  
pp. 2851-2858 ◽  
Author(s):  
Eric Hamrin Senorski ◽  
Eleonor Svantesson ◽  
Kurt P. Spindler ◽  
Eduard Alentorn-Geli ◽  
David Sundemo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Risk Factor ◽  
Acl Reconstruction ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Knee Ligament ◽  
Related Risk ◽  
Anterior Cruciate

Background: Factors relating to the patient and anterior cruciate ligament (ACL) reconstruction may help to identify prognostic factors of long-term outcome after reconstruction. Purpose: To determine 10-year risk factors for inferior knee function after ACL reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: Prospectively collected data from the Swedish National Knee Ligament Register were extracted for patients who underwent ACL reconstruction between January 2005 and December 2006. Patients who had no data at the 10-year follow-up for the Knee injury and Osteoarthritis Outcome Score (KOOS) were excluded. Multivariable proportional odds regression modeling was used to assess 10-year patient- and surgery-related risk factors across all the KOOS subscales and the KOOS4 (mean score of 4 subscales: pain, knee-related symptoms, function in sport and recreation, and knee-related quality of life). Results: A total of 874 (41%) patients were included (male, 51.5%; median age at the time of ACL reconstruction, 27.5 years [range, 11.2-61.5 years]). An increase in the severity of concomitant articular cartilage injuries resulted in a reduced KOOS on 4 subscales (odds ratio, 0.64-0.80; P < .05). A higher preoperative KOOS pain score increased the odds of a higher score on the pain, symptoms, and sport subscales and the KOOS4. In addition, a higher preoperative body mass index was a significant risk factor for lower scores on 3 KOOS subscales and the KOOS4. No patient- or surgery-related predictor was significant across all KOOS subscales. Conclusion: This 10-year risk factor analysis identified several factors that can affect long-term knee function after ACL reconstruction. Most risk factors were related to preoperative patient-reported outcome and potentially modifiable. On the other hand, most of the surgery-related risk factors were nonmodifiable. Nevertheless, this information may be helpful to physicians and physical therapists counseling patients on their expectations of outcome after ACL reconstruction.

Fifteen-Year Audit of Anterior Cruciate Ligament Reconstructions in the Australian Football League From 1999 to 2013: Return to Play and Subsequent ACL Injury

2018 ◽  
Vol 46 (14) ◽  
pp. 3353-3360 ◽  
Author(s):  
Courtney C.H. Lai ◽  
Julian A. Feller ◽  
Kate E. Webster
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Risk Ratio ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Return To Play ◽  
Rates Of Return ◽  
Australian Football League ◽  
Australian Football ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injury has been a major cause of missed game time among Australian Football League (AFL) players. Return to play after ACL reconstruction is not always achieved, even among elite athletes. The rate of subsequent ACL injury in the AFL from 1990 to 2000 was high as compared with that of other elite sports. Purpose: To determine the rates of return to play and subsequent ACL injury after ACL reconstruction among AFL players from 1999 to 2013 and to explore factors associated with differing rates of return to play and subsequent ACL injury. Study Design: Case series; Level of evidence, 4. Methods: A total of 158 AFL players who underwent ACL reconstruction were identified from a prospectively maintained registry of AFL player injuries. Further data were gathered from official playing statistics, surgical records, and structured phone interviews. Results: The rate of return to play after an initial ACL injury was 77% (121 of 158 players). Greater preinjury playing experience and earlier selection in the AFL draft were associated with higher rates of return to play. The rate of subsequent ACL injury to either knee was 30% (48 of 158 players) and was especially high among players aged <21 years (23 of 46 players, 50%). After subsequent ACL injury, 34 of 48 players (71%) returned to play. In primary ACL reconstruction, the use of Ligament Augmentation and Reconstruction System grafts resulted in a faster return to play ( P = .001) but had a higher risk of subsequent revision reconstruction (risk ratio = 2.8, P = .048). Family history of ACL injury was associated with an increased risk of subsequent contralateral ACL injury (risk ratio = 3.8, P = .002). Conclusion: Most AFL players who underwent ACL reconstruction returned to play at least 1 AFL match. The high rate of subsequent ACL injury among AFL players demonstrates the highly demanding nature of Australian football, particularly at the elite level. The risk factors for subsequent ACL injury should be considered carefully when treatment and rehabilitation decisions are made for these high-demand athletes.

Playing Performance After Anterior Cruciate Ligament Reconstruction Among Australian Football League Players From 1999 to 2013

2019 ◽  
Vol 47 (7) ◽  
pp. 1550-1556
Author(s):  
Courtney C.H. Lai ◽  
Julian A. Feller ◽  
Kate E. Webster
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Odds Ratio ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Return To Play ◽  
Average Level ◽  
Australian Football League ◽  
Australian Football ◽  
Anterior Cruciate

Background: Achieving preinjury levels of athletic performance has been challenging for elite athletes after anterior cruciate ligament (ACL) reconstruction. Although a recent study found that 77% of Australian Football League (AFL) players who underwent ACL reconstruction from 1999 to 2013 returned to play at the highest level, the study did not indicate how consistently or well they were able to play. Purpose: To identify the number of AFL players who returned to play consistently over 2 seasons after ACL reconstruction, compare their playing performance in these seasons with preinjury performance, and evaluate factors associated with returning to preinjury levels of performance. Study Design: Case series; Level of evidence, 4. Methods: Analysis included 104 AFL players who underwent ACL reconstruction between 1999 and 2013. All had played at least 10 AFL matches in 1 season before ACL injury. Ranking points, as devised by AFL statisticians, were used to measure individual playing performance. Results: Of the 104 players who played at least 10 matches in 1 season before ACL injury, 53 (51%) returned to play at least 10 matches in 2 seasons after surgery. Of these 53 players, 36 (68%) returned to their preinjury levels of performance. The 17 remaining players who did not return to their preinjury performance still performed comparably to the AFL average level after surgery. Players <25 years old (odds ratio = 2.9, P = .01) or <90 kg (odds ratio = 2.7, P = .03) had greater odds of returning to their preinjury levels of performance. Conclusion: Returning to play on a consistent basis was a substantial challenge for AFL players after ACL reconstruction. However, among players who did return to play consistently over 2 seasons, their postsurgery average performance was comparable with the AFL average level of performance, and two-thirds returned to their preinjury levels of performance. Younger and lighter players were more likely to return to their preinjury levels of performance, possibly given the nature of AFL club playing list management decisions.

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

2019 ◽  
Vol 12 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Alberto Grassi ◽  
Luca Macchiarola ◽  
Matteo Filippini ◽  
Gian Andrea Lucidi ◽  
Francesco Della Villa ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Incidence Rate ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Injury Incidence ◽  
Acl Injuries ◽  
Professional Soccer ◽  
Incidence Proportion ◽  
Anterior Cruciate

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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