High rate of second ACL injury following ACL reconstruction in male professional footballers: an updated longitudinal analysis from 118 players in the UEFA Elite Club Injury Study

Villa, F.; Hägglund, Martin; Villa, S.; Ekstrand, Jan; Waldén, Markus

doi:10.1136/bjsports-2020-103555

Cited by 77 publications

(62 citation statements)

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“…Despite the open debate on the use of targeted neuromuscular training [ 4 , 24 ], “at-risk” athletes were found to benefit more from additional customized programs focused on movement quality [ 20 ]. Given the growing incidence of ACL injuries in males and (recently) in females footballers [ 1 , 3 , 13 ], large-scale screenings and a broader awareness of the ACL injury risk are desirable.…”

Section: Discussionmentioning

confidence: 99%

“…The anterior cruciate ligament (ACL) injury risk reduction is a current open question for the sports medicine community. The investigation of situational patterns that lead to ACL injury has gained importance in the light of primary and secondary injury prevention [ 13 , 18 , 19 , 29 ]. Recent ACL injury video analysis studies [ 6 , 11 , 22 ] identified pressing/tackling as the most common situational patterns for ACL injury in football.…”

Section: Introductionmentioning

confidence: 99%

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A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

Paolo

Zaffagnini

Tosarelli³

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The deceleration (pressing) is a common situational pattern leading to anterior cruciate ligament (ACL) injury in football. Although mainly assessed for performance purposes, a stronger focus on movement quality might support the screening of at-risk athletes. The aim of the present study was to describe a 2D scoring system for the assessment of the deceleration task and to associate it with the knee joint loading (knee abduction moment) evaluated through the gold standard 3D motion capture. The hypothesis was that lower 2D scores would be associated with higher knee joint loading. Methods Thirty-four competitive football (soccer) players (age 22.8 ± 4.1, 16 females) performed a series of deceleration tasks. 3D motion analysis was recorded using ten stereophotogrammetric cameras, a force platform, and three high-speed cameras. The 2D qualitative assessment was performed via a scoring system based on the video analysis of frontal and lateral planes joint kinematics for five scoring criteria. The intra- and inter-rater reliabilities were calculated for each 2D scoring criteria. The peak knee abduction moment was extracted and grouped according to the results of the 2D evaluation. Results An ICC > 0.94 was found for all the 2D scoring criteria, both for intra-rater and inter-rater reliability. The players with low 2D frontal plane scores and low total scores (0–4) showed significantly higher peak knee abduction moment values (p < 0.001). A significant negative rank correlation was found between the total score and the peak knee abduction moment (ρ = − 0.25, p < 0.001). Conclusions The qualitative 2D scoring system described successfully discerned between athletes with high and low knee joint loading during a deceleration task. The application of this qualitative movement assessment based on a detailed and accurate scoring system is suitable to identify players and patients with high knee joint loading (high knee abduction moments) and target additional training in the scenario of the primary and secondary ACL injury risk reduction. Level of evidence Level IV.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

Paolo

Zaffagnini

Tosarelli³

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“…Schwer wiegt ebenfalls die Tatsache, dass bei 23–35 % der Sportler*innen innerhalb der ersten zwei Jahre nach einer VKB-Rekonstruktion das VKB erneut reißt. Im Profifußball wurde sogar eine Reverletzungsrate von 42 % innerhalb von 5 Jahren berichtet 9 . Beachtlich ist auch die Erkenntnis, dass ehemals verletzte Kniegelenke 7–14 Jahre nach VKB Rekonstruktion in 40–90 % der Fälle eine stärkere radiologische Arthrose zeigen als die kontralaterale Seite 40 .…”

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“…Der lange Rehabilitationszeitraum ist bei Patient*innen mit einer großen psychischen Belastung verbunden. Über die Rückkehrraten zum Wettkampfsport nach einer VKB-Reruptur ist wenig bekannt 9 .…”

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“…Wahrscheinlich ist, dass neuromuskuläre Fähigkeiten, die diese Tests nicht erfassen können, eine entscheidende Rolle in der Prävention spielen 19 . Beispielsweise ist bekannt, dass das Reruptur-Risiko bei professionellen männlichen Fußballspielern deutlich erhöht ist, wenn die erste Verletzung ohne Gegnerkontakt passierte 9 . Dies impliziert, dass bereits vor dem Riss prädisponierende Faktoren bestanden oder die Spielenden durch andere Umwelteinflüsse beeinträchtigt waren.…”

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Bewusst unterbewusst – Neuromuskuläres Training nach VKB-Ruptur

Köcker¹

2022

Sportphysio

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Optimal Timing of Anterior Cruciate Ligament Reconstruction in Patients With Anterior Cruciate Ligament Tear

Shen

Liu

et al. 2022

JAMA Netw Open

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ImportanceThe timing of surgery has been regarded as a key factor in anterior cruciate ligament reconstruction (ACLR), and early vs delayed ACLR remains a controversial topic.ObjectiveTo synthesize up-to-date published data from randomized clinical trials (RCTs) comparing early vs elective delayed ACLR for patients with ACL deficiency, in terms of clinical outcomes and complications.Data SourcesThe PubMed, Cochrane Library, and Web of Science databases were systematically searched until September 9, 2022.Study SelectionAll published RCTs comparing clinical and functional outcomes and complications associated with early ACLR vs elective delayed ACLR.Data Extraction and SynthesisTwo reviewers independently extracted relevant data and assessed the methodological quality following the PRISMA guidelines.Main Outcomes and MeasuresDue to the clinical heterogeneity, the random-effects model was preferred. The primary outcomes were functional outcomes and complications. The Mantel-Haenszel test was used to evaluate dichotomous variables and the inverse variance method was used to assess continuous variables.ResultsThis meta-analysis included 972 participants in 11 RCTs stratified by follow-up duration. The following factors did not differ between early and delayed ACLR: operative time (mean difference, 4.97; 95% CI, −0.68 to 10.61; P = .08), retear (OR, 1.52; 95% CI, 0.52-4.43; P = .44), and infection (OR, 3.80; 95% CI, 0.77-18.79; P = .10). There were also no differences between groups in range of motion, knee laxity, International Knee Documentation Committee (IKDC rating scale), and Tegner score. IKDC score (mean difference, 2.77; 95% CI, 1.89-3.66; P &lt; .001), and Lysholm score at 2-year follow-up (mean difference, 2.61; 95% CI, 0.74-4.48; P = .006) significantly differed between early and delayed ACLR. In addition, the timing of surgery was redefined in the included RCTs and subgroup analyses were performed, which validated the robustness of the principal results.Conclusion and RelevanceThis systematic review and meta-analysis found that early ACLR was not superior to delayed ACLR in terms of most factors analyzed, except for IKDC and Lysholm scores. This information should be available to patients with ACL deficiency and clinicians as part of the shared decision-making process of treatment selection.

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High rate of second ACL injury following ACL reconstruction in male professional footballers: an updated longitudinal analysis from 118 players in the UEFA Elite Club Injury Study

Cited by 77 publications

References 48 publications

A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

Bewusst unterbewusst – Neuromuskuläres Training nach VKB-Ruptur

Optimal Timing of Anterior Cruciate Ligament Reconstruction in Patients With Anterior Cruciate Ligament Tear

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