Evidence map›Paper›PMID 33846157›Full record

ArticleBritish journal of sports medicine2021

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.

Francesco Della Villa, Martin Hägglund, Stefano Della Villa, Jan Ekstrand, Markus Waldén

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In one paragraph

Article in British journal of sports medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Francesco Della VillaEducation and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy.ORCID http://orcid.org/0000-0001-9379-6666
Martin HägglundFootball Research Group, Linköping University, Linköping, Sweden martin.hagglund@liu.se.ORCID http://orcid.org/0000-0002-6883-1471
Stefano Della VillaEducation and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy.
Jan EkstrandFootball Research Group, Linköping University, Linköping, Sweden.ORCID http://orcid.org/0000-0002-6092-266X
Markus WaldénFootball Research Group, Linköping University, Linköping, Sweden.ORCID http://orcid.org/0000-0002-6790-4042

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStudies on subsequent anterior cruciate ligament (ACL) ruptures and career length in male professional football players after ACL reconstruction (ACLR) are scarce.

aimTo investigate the second ACL injury rate, potential predictors of second ACL injury and the career length after ACLR. STUDY

designProspective cohort study.

settingMen's professional football.

methods118 players with index ACL injury were tracked longitudinally for subsequent ACL injury and career length over 16.9 years. Multivariable Cox regression analysis with HR was carried out to study potential predictors for subsequent ACL injury.

resultsMedian follow-up was 4.3 (IQR 4.6) years after ACLR. The second ACL injury rate after return to training (RTT) was 17.8% (n=21), with 9.3% (n=11) to the ipsilateral and 8.5% (n=10) to the contralateral knee. Significant predictors for second ACL injury were a non-contact index ACL injury (HR 7.16, 95% CI 1.63 to 31.22) and an isolated index ACL injury (HR 2.73, 95% CI 1.06 to 7.07). In total, 11 of 26 players (42%) with a non-contact isolated index ACL injury suffered a second ACL injury. RTT time was not an independent predictor of second ACL injury, even though there was a tendency for a risk reduction with longer time to RTT. Median career length after ACLR was 4.1 (IQR 4.0) years and 60% of players were still playing at preinjury level 5 years after ACLR.

conclusionsAlmost one out of five top-level professional male football players sustained a second ACL injury following ACLR and return to football, with a considerably increased risk for players with a non-contact or isolated index injury.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionSoccerHumansMaleProspective StudiesReturn to SportACLanterior cruciate ligamentfootballrehabilitation

Identifiers

PMID33846157
PMCPMC8606446

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.