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Krutsch W, Kobes T, Huber L, Szymski D, Geßlein M, Rüther J, Alt V, Weber J. [Complex knee injuries in football : Management from injury to return to competition]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:438-448. [PMID: 38801525 DOI: 10.1007/s00132-024-04508-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Knee joint injuries are a regular and serious injury in football, often resulting in a long period of absence for players and are, therefore, a significant disadvantage for clubs. The various structures of the knee joint, such as ligaments, meniscus or cartilage, are exposed to the risk of injury due to different sport-specific situations in football and require different and specific therapeutic approaches for their adequate healing. TREATMENT Both surgical and conservative treatment measures have been well investigated scientifically, especially for knee joint injuries in football, so that a successful and sustainable return to play on field is highly possible. Only in professional football is there a deviation from the usual standard of treatment in special situations in order to meet the demands and goals of professional footballers. In order to do address different subpopulations in football in the various injury types, both in treatment and in the return to play decision and, thus, sustainable secondary prevention, in addition to knowledge of scientific evidence on knee joint injuries, basic experience in the sport in which the patients with knee joint injuries are active is also useful.
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Affiliation(s)
- Werner Krutsch
- SportDocsFranken, Zentrum für Kniechirurgie, Elisabeth-Selbert-Platz 1, 90473, Nürnberg, Deutschland.
- Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland.
| | - Thomas Kobes
- SportDocsFranken, Zentrum für Kniechirurgie, Elisabeth-Selbert-Platz 1, 90473, Nürnberg, Deutschland
| | - Lorenz Huber
- Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland
| | - Dominik Szymski
- Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland
| | - Markus Geßlein
- Klinik für Orthopädie und Unfallchirurgie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität Nürnberg, Nürnberg, Deutschland
| | - Johannes Rüther
- Klinik für Orthopädie und Unfallchirurgie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität Nürnberg, Nürnberg, Deutschland
| | - Volker Alt
- Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland
| | - Johannes Weber
- Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland
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Krutsch W, Hadji A, Tröß T, Szymski D, Aus der Fünten K, Gärtner B, Alt V, Meyer T. No increased injury incidence in the German Bundesliga after the SARS-CoV-2 virus lockdown. Arch Orthop Trauma Surg 2022; 142:1571-1578. [PMID: 34286365 PMCID: PMC8294279 DOI: 10.1007/s00402-021-04060-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/03/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION The coronavirus lockdown in 2020 resulted in a worldwide suspension of professional sports. The first major professional football league to restart after the lockdown was the German Bundesliga. This study investigates whether the injury incidence increased after the restart of the season with only 9 days of regular preparation time and without any friendly matches in comparison to three control periods. MATERIALS AND METHODS In a prospective cohort study, injury analysis (at least 1 day of absence from official football matches or training sessions) of the German Bundesliga registry was standardised according to Hägglund et al. (Br J Sports Med 39:340-346, 2005) and Fuller et al. (Clin J Sports Med 16:97-106, 2006) for data collection and to previous publications for the validated use of media sources for injury registration. The study period after the lockdown in May and June of the 2019-2020 season was compared to three control periods: the period directly before the lockdown, the beginning of the 2019-2020 season and the 2018-2019 season final. RESULTS The nine match days after the restart of the 2019-2020 season showed an overall injury incidence of 4.9 per 1000 h football. This rate was significantly lower than that of the previous season final (9 last match days, overall injury incidence: 6.9 per 1000 h football; p < 0.001) and not increased compared to the rates after the summer break (9 match days; incidence: 5.5/1000 h, p > 0.05) or the winter break (8 match days; incidence: 5.6/1000 h, p > 0.05). CONCLUSION The period after the unexpected break in the 2019-2020 season due to the coronavirus lockdown and the rapid return to competition showed no increase in the injury rate compared to the pre-lockdown period and a lower injury rate than in the previous season final. The unintentional mid-season rest with its potential for physical recovery and individual fitness training seems to have had a positive effect on injury occurrence.
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Affiliation(s)
- Werner Krutsch
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
| | - Abed Hadji
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tobias Tröß
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Dominik Szymski
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Barbara Gärtner
- Department of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
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Krutsch V, Krutsch W, Härtl J, Bloch H, Alt V, Klein C, Reinsberger C, Seiffert R, Huber L, Weber J. Head injuries in professional football (soccer): Results of video analysis verified by an accident insurance registry. PLoS One 2021; 16:e0255695. [PMID: 34379643 PMCID: PMC8357092 DOI: 10.1371/journal.pone.0255695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Video analysis is one of the most commonly applied methods for analysing football injuries. PURPOSE The objective of this study was to assess the accuracy of video analysis for recording head injuries in professional football from official matches in the four highest men's professional football leagues in Germany. METHODS In this cohort study, head injuries detected by means of video analysis of all official matches over one season (2017-18) were compared to head injuries registered with the German statutory accident insurance. RESULTS Our video analysis yielded 359 head injuries of 287 players. The comparison of head injuries found in our video analysis to those registered with the accident insurance only yielded a match in 23.1% (n = 83), which presents a rather low verification rate. The verification rates varied between the leagues (7.0-30.8%). All injuries documented in the accident insurance registry were found in the video analysis (100%). The types of head injury most often verified by the accident insurance registry (n = 83) were contusion (43.4%), bone fractures (19.3%) and skin lacerations (18.1%). Only 66 of the 359 head injuries (18.4%) resulted in absence from at least one training session and involved a mean time loss of 18.5 days (1-87 days). CONCLUSION The mismatch between the number of head injuries found in the video analysis and head injuries registered with the accident insurance is an important methodological issue in scientific research. The low verification rate seems to be due to the unclear correlation between injury severity and clinical consequences of head injuries detected by means of video analysis and the failure of football clubs to register minor head injuries with the accident insurance.
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Affiliation(s)
- Volker Krutsch
- Department of Otorhinolaryngology, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Werner Krutsch
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
- SportDocsFranken, Nuremberg, Germany
| | - Jonas Härtl
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Hendrik Bloch
- Department of Sports Injury Prevention, VBG, Germany, Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Christian Klein
- Department of Sports Injury Prevention, VBG, Germany, Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Claus Reinsberger
- Department of Sports Medicine, University of Paderborn, Paderborn, Germany
| | - Robin Seiffert
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Lorenz Huber
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Johannes Weber
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
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Volker K, Julia O, Werner K, Oliver L, Johannes W, Maximilian K, Siegmund L, Matthias K, Volker A, Michael W. Decision-making to stop or continue playing after football injuries - a systematic video analysis of 711 injury situations in amateur football. Eur J Sport Sci 2021; 22:1459-1465. [PMID: 34157959 DOI: 10.1080/17461391.2021.1943717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Scientific injury registration via video analysis is lacking in amateur football. The purpose of this study was to analyse match injury situations with a focus on the decisions made by players and referees after sustaining a football trauma. In a retrospective cohort study, traumatic injuries sustained in any of the 305 matches of the highest amateur level (4th league) in Germany in the 2015-16 season were assessed by means of video analysis and a standardised video protocol. In total, 711 traumatic incidents at 919 different body regions had been recorded. The three most frequently injured body regions were the ankles (34.1%), the head (17.5%) and the knees (17.0%). 90% (n = 156) of head injuries were direct contact injuries, this percentage was significantly higher than that of contact injuries on ankle (68.4%; p < 0.001) or knee (52.6%; p = 0.001). Referees decided on foul play significantly more often in case of knee injuries (57.1%; p = 0.002) or ankle injuries (64.5%; p < 0.001) than in head injuries (39.8%). Only 26.1% of players with a head injury opted for substitution, which was lower than after ankle (27.8%; p = 0.78) and knee injuries (34.0%; p = 0.13). In conclusion, amateur football is associated with a considerable number of injury situations that are followed by match interruptions and the substitution of players. Players and referees decided to continue playing more often after a head injury than after an injury to other body regions. An advanced education programme on the risks and management of head injuries in football is required to prevent long-term health consequences.
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Affiliation(s)
- Krutsch Volker
- Department of Otorhinolaryngology, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Oberhauser Julia
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Krutsch Werner
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany.,SportDocsFranken, Nuremberg, Germany
| | - Loose Oliver
- Clinic of Paediatric Surgery, Olgahospital, Clinic Stuttgart, Stuttgart, Germany
| | - Weber Johannes
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Kerschbaum Maximilian
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Lang Siegmund
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Koch Matthias
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Alt Volker
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Worlicek Michael
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
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Lacki JF. High training/competition ratio, less incidence of injury? Professional football calendar exploration. APUNTS SPORTS MEDICINE 2021. [DOI: 10.1016/j.apunsm.2020.100338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Krutsch W, Loose O. Gesamtkonzept zur Verletzungsprävention von schweren Knieverletzungen im Leistungsfußball. ARTHROSKOPIE 2020. [DOI: 10.1007/s00142-020-00390-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ekstrand J, Krutsch W, Spreco A, van Zoest W, Roberts C, Meyer T, Bengtsson H. Time before return to play for the most common injuries in professional football: a 16-year follow-up of the UEFA Elite Club Injury Study. Br J Sports Med 2019; 54:421-426. [PMID: 31182429 PMCID: PMC7146935 DOI: 10.1136/bjsports-2019-100666] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2019] [Indexed: 12/12/2022]
Abstract
Objectives The objective was to describe the typical duration of absence following the most common injury diagnoses in professional football. Methods Injuries were registered by medical staff members of football clubs participating in the Union of European Football Association Elite Club Injury Study. Duration of absence due to an injury was defined by the number of days that passed between the date of the injury occurrence and the date when the medical team allowed the player to return to full participation. In total, 22 942 injuries registered during 494 team-seasons were included in the study. Results The 31 most common injury diagnoses constituted a total of 78 % of all reported injuries. Most of these injuries were either mild (leading to a median absence of 7 days or less, 6440 cases = 42%) or moderate (median absence: 7–28 days, 56% = 8518 cases) while only few (2% = 311 cases) were severe (median absence of >28 days). The mean duration of absence from training and competition was significantly different (p < 0.05) between index injuries and re-injuries for six diagnoses (Achilles tendon pain, calf muscle injury, groin adductor pain, hamstring muscle injuries and quadriceps muscle injury) with longer absence following re-injuries for all six diagnoses Conclusions The majority of all time loss due to injuries in professional football stems from injuries with an individual absence of up to 4 weeks. This article can provide guidelines for expected time away from training and competition for the most common injury types as well as for its realistic range.
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Affiliation(s)
- Jan Ekstrand
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden .,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Werner Krutsch
- Department of Trauma Surgery, Universitatsklinikum Regensburg, Regensburg, Germany
| | - Armin Spreco
- Department of Medical and Health Sciences, Athletics Research Centre, Linköping University, Linköping, Sweden
| | - Wart van Zoest
- Department of Orthopaedic Surgery, St Anna Hospital, Eindhoven, The Netherlands
| | | | - Tim Meyer
- Institute of Sports and Preventive Medicine, University of Saarland, Saarbrücken, Germany
| | - Håkan Bengtsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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