Summary

Professional AFL male Australian Rules footballers with a family history of ACL injury were at 3 times greater odds of having a primary ACL injury than their team mates without a family history.

Abstract

Background

Australian Rules football is the most popular football code in Australia and is the biggest cause for anterior cruciate ligament (ACL) injuries in the sporting population due to the high exposure to repeated change of direction, jumping, landing and tackling. The premier professional competition is the Australian Football League (AFL) in which ACL injuries create a major burden in time lost from competition. A family history of ACL injury has been reported to increase the odds of sustaining a first ACL injury by up to 2.5 times. This risk has not been investigated in an elite cohort playing a high risk sport.

Purpose

To determine if male AFL players with a family history of ACL injury were at increased odds of having an ACL injury.

Study Design
Cohort Study

Methods

All 10 AFL teams in the state of Victoria participated in the study. Players were asked to complete a survey detailing their age, time in the AFL, personal ACL injury history and details of immediate family members who had sustained an ACL injury. A 2x2 contingency table was used to calculate Odds Ratios (OR) and 95% confidence intervals (CI) to assess for a significant difference in the presence of a positive family history in those who had sustained an ACL injury and those who had not.

Results

Complete data was obtained from 410 out of 430 (95.3%) potential players. There were 4 players who were unsure of their immediate family history for ACL injury and were removed from the analysis. The mean age of the players was 23.6 years (range: 18-33) and they had been part of an AFL squad for a mean of 6 years. 32 (7.8%) players had sustained an ACL injury. 19 (59.4%) players had sustained their ACL injury whilst in the AFL and 13 (40.6%) had sustained their injury prior to being drafted.
15 out of 32 (46.8%) players who had sustained an ACL injury reported having a family history of ACL injury, compared to 82 out of 378 (21.7%) who had not sustained an ACL injury. Players with a positive family history were at significantly increased odds of having sustained an ACL injury compared to those without (OR 3.2 [95% CI 1.55-6.76], p<0.001).

Conclusions

Professional AFL male Australian Rules footballers with a family history of ACL injury were at 3 times greater odds of having an ACL injury than their team mates without a family history. This is greater than what has been reported in sub-elite population groups in other sports. Athletes playing Australian Rules football should be screened for family history of ACL injury and encouraged to complete targeted injury reduction programs.