Summary

This homogeneous cohort of professional league soccer players underscores a concerning increase in the incidence of ACL injuries over a short period. Our study identified several factors contributing to these ACL ruptures, with no single determinant emerging as the primary cause.

Abstract

Background

Anterior cruciate ligament (ACL) injuries are common in soccer, and in professional players they pose a significant risk due to their potentially career-threatening nature. According to published reports, one ACL injury is typically expected per team of 25 players every two years. However, this year in Argentina, an alarming number of 22 first-division male soccer players sustained an ACL injury within just three months.

Aim

To describe the mechanisms, situational patterns, and biomechanics behind these 22 ACL injuries among professional male soccer players.

Methods

The evaluation period was from January to April 2024. The number of injuries was recorded using publicly accessible information available online. We included only complete ACL ruptures treated surgically. The following variables were analyzed: age, player position, team, playing surface, weather conditions, training or official match, match period, injured side and dominant leg, and type of footwear used at the time of injury. A video analysis was conducted to evaluate the injury mechanisms.

Results

The average age at the time of injury was 26 years (range 20-35). Four players experienced a reinjury after a previous ACL reconstruction. All injuries occurred on grass fields. Injuries were recorded during 12 official matches, 5 exhibition matches, and 5 training sessions. Only 2 stadiums had more than one injury, and only 2 teams had 2 injured players each. Rain was a factor in only one match. Of the injuries that occurred during matches, 5 happened in the first half and 12 in the second half. The right knee was affected in 14 players. In 12 cases (54%), the injured knee was on the player's dominant side. The average height was 1.78 meters. The positions of the injured players were: 9 forwards, 7 midfielders, and 6 defenders. All players wore boots with a lateral stud configuration, and 3 different brands were identified. Based on video analysis, 31% of injuries were caused by a direct mechanism, 23% by indirect contact, and 46% occurred without contact.

Conclusion

This homogeneous cohort of professional league soccer players underscores a concerning increase in the incidence of ACL injuries over a short period. Our study identified several factors contributing to these ACL ruptures, with no single determinant emerging as the primary cause. The significant rise in injury rates highlights the severity of the problem and emphasizes the urgent need for intervention. We propose that the main contributing factors include the high frequency of matches played at excessive intensity, reduced training time, limited focus on injury prevention, and inadequate rest periods. Addressing these factors is crucial for mitigating the risk and severity of ACL injuries.