To prospectively evaluate risk factors for acute time-loss knee injury, in particular ACL injury, in female youth football players.
Risk factors were studied in 4556 players aged 12–17 years from a randomised controlled trial during the 2009 season. Covariates were both intrinsic (body mass index, age, relative age effect, onset of menarche, previous acute knee injury or ACL injury, current knee complaints, and familial disposition of ACL injury) and extrinsic (no. of training sessions/week, no. of matches/week, match exposure ratio, match play with other teams, and artificial turf exposure). Hazard ratios (HRs) and 95 % confidence intervals (CIs) were calculated from individual variable and multiple Cox regression analyses.
Ninety-six acute knee injuries were recorded, 21 of them ACL injuries. Multiple Cox regression showed a fourfold higher ACL injury rate for players with familial disposition of ACL injury (HR 3.57; 95 % CI 1.48–8.62). Significant predictor variables for acute knee injury were age >14 years (HR 1.97; 95 % CI 1.30–2.97), knee complaints at the start of the season (HR 1.98; 95 % CI 1.30–3.02), and familial disposition of ACL injury (HR 1.96; 95 % CI 1.22–3.16). No differences in injury rates were seen when playing on artificial turf compared with natural grass.
Female youth football players with a familial disposition of ACL injury had an increased risk of ACL injury and acute knee injury. Older players and those with knee complaints at pre-season were more at risk of acute knee injury. Although the predictive values were low, these factors could be used in athlete screening to target preventive interventions.
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We thank all the coaches and players who participated in the study as well as the study therapists and study physicians constituting the medical support to the teams. Professor Per Renström, MD, PhD, Mrs Annica Näsmark, PT, and Mrs Anneli Gustafsson from the Swedish Football Association (FA) are gratefully acknowledged for study assistance. Isam Atroshi, MD, PhD, Philippe Wagner, MSc, and Henrik Magnusson, MSc, are acknowledged for their contribution to the original RCT. The study was financially supported by the Swedish FA and the Folksam Insurance Company. This research also received grants from the Swedish National Centre for Research in Sports and the Hässleholm Hospital.
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The authors declare that they have no conflict of interest.
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Hägglund, M., Waldén, M. Risk factors for acute knee injury in female youth football. Knee Surg Sports Traumatol Arthrosc 24, 737–746 (2016). https://doi.org/10.1007/s00167-015-3922-z
- Female athlete