@article {Della Villabjsports-2019-101247, author = {Francesco Della Villa and Matthew Buckthorpe and Alberto Grassi and Alberto Nabiuzzi and Filippo Tosarelli and Stefano Zaffagnini and Stefano Della Villa}, title = {Systematic video analysis of ACL injuries in professional male football (soccer): injury mechanisms, situational patterns and biomechanics study on 134 consecutive cases}, elocation-id = {bjsports-2019-101247}, year = {2020}, doi = {10.1136/bjsports-2019-101247}, publisher = {British Association of Sport and Excercise Medicine}, abstract = {Background A few small studies have reported on the mechanisms of ACL injury in professional male football.Aim To describe the mechanisms, situational patterns and biomechanics (kinematics) of ACL injuries in professional male football matches.Methods We identified 148 consecutive ACL injuries across 10 seasons of professional Italian football. 134 (90\%) injury videos were analysed for mechanism and situational pattern, while biomechanical analysis was possible in 107 cases. Three independent reviewers evaluated each video. ACL injury epidemiology (month), timing within the match and pitch location at the time of injury were also reported.Results 59 (44\%) injuries were non-contact, 59 (44\%) were indirect contact and 16 (12\%) were direct contact. Players were frequently perturbed immediately prior to injury. We identified four main situational patterns for players who suffered a non-contact or an indirect contact injury: (1) pressing and tackling (n=55); (2) tackled (n=24); (3) regaining balance after kicking (n=19); and (4) landing from a jump (n=8). Knee valgus loading (n=83, 81\%) was the dominant injury pattern across all four of these situational patterns (86\%, 86\%, 67\% and 50\%, respectively). 62\% of the injuries occurred in the first half of the matches (p\<0.01). Injuries peaked at the beginning of the season (September{\textendash}October) and were also higher at the end of the season (March{\textendash}May).Conclusions 88\% of ACL injuries occurred without direct knee contact, but indirect contact injuries were as frequent as non-contact injuries, underlying the importance of mechanical perturbation. The most common situational patterns were pressing, being tackled and kicking.}, issn = {0306-3674}, URL = {https://bjsm.bmj.com/content/early/2020/06/19/bjsports-2019-101247}, eprint = {https://bjsm.bmj.com/content/early/2020/06/19/bjsports-2019-101247.full.pdf}, journal = {British Journal of Sports Medicine} }