The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from a gender-related perspective
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Football (soccer), the most popular sport worldwide, is associated with a high injury risk, and the knee joint is often affected. Several studies have found female players to be more susceptible to knee injury, anterior cruciate ligament (ACL) injury in particular, compared to their male counterparts. There is, however, some controversy regarding the magnitude of this risk increase and a few studies have found no differences. The influence of age and activity type on gender-related differences in injury risk is only scarcely investigated. In this paper, the literature reporting gender-specific ACL injury risk in football is reviewed. A literature search yielded 33 relevant articles that were included for review. These show that female players have a 2–3 times higher ACL injury risk compared to their male counterparts. Females also tend to sustain their ACL injury at a younger age than males, and a limiting factor in the existing literature is that age is not adjusted for in comparisons of ACL injury risk between genders. Furthermore, the risk increase in females is primarily evident during match play, but type of exposure is also rarely adjusted for. Finally, the studies included in this review share important methodological limitations that are discussed as a starting point for future research in the field.
KeywordsACL Epidemiology Female Risk Sex Injury
Conflict of interest statement
The authors declare that they have no conflict of interest.
- 3.Alentorn-Geli E, Myer GD, Silvers HJ, Samitier G, Romero D, Lázaro-Haro C, Cugat R (2009) Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors. Knee Surg Sports Traumatol Arthrosc 17:705–729CrossRefPubMedGoogle Scholar
- 4.Alentorn-Geli E, Myer GD, Silvers HJ, Samitier G, Romero D, Lázaro-Haro C, Cugat R (2009) Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 2: A review of prevention programs aimed to modify risk factors and to reduce injury rates. Knee Surg Sports Traumatol Arthrosc 17:859–879CrossRefPubMedGoogle Scholar
- 10.Becker A, Gaulrapp H, Hess H (2006) Verletzungen im Frauenfussball—Ergebnisse einer prospektiven Jahresstudie. In Zusammenarbeit mit dem Deutschen Fussballbund (DFB). Sportverl Sportschaden 20:196–200Google Scholar
- 18.Faude O, Meyer T, Federspiel B, Kindermann W (2009) Verletzungen im deutschen Profifußball–eine analyse auf Basis von Medieninformationen. Deutsche Zeitschrift für Sportmedizin 60:139–144Google Scholar
- 30.Mandelbaum BR, Silvers HS, Watanabe DS, Knarr JF, Thomas SD, Griffin LY, Kirkendall DT, Garrett W Jr (2005) Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes. Am J Sports Med 33:1003–1010CrossRefPubMedGoogle Scholar
- 32.Miyasaka KC, Daniel DM, Stone ML, Hirshman P (1991) The incidence of knee ligament injuries in the general population. Am J Knee Surg 4:3–8Google Scholar
- 38.Renström P, Ljungqvist A, Arendt E, Beynnon B, Fukubayashi T, Garrett W, Georgoulis T, Hewett TE, Johnson R, Krosshaug T, Mandelbaum B, Micheli L, Myklebust G, Roos E, Roos H, Schamasch P, Shultz S, Werner S, Wojtys E, Engebretsen L (2008) Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med 42:394–412CrossRefPubMedGoogle Scholar
- 48.Waldén M, Hägglund M, Magnusson H, Ekstrand J (2010) Anterior cruciate ligament injury in elite football: a prospective three-cohort study. Knee Surg Sports Traumatol Arthrosc. doi: 10.1007/s00167-010-1170-9