Anterior Cruciate Ligament Injuries in Football Players: Timing, Mechanism, Player Position, and Associated Factors in a Cohort of 62 Patients from Amateur Football Tournament

Abstract

Background: Anterior cruciate ligament (ACL) injuries are common in football and often linked to fatigue, non-contact mechanisms, and environmental factors. This study examines ACL injuries in amateur tournaments cohort, focusing on injury timing, mechanism, player position, and associated risk factors, with emphasis on position-mechanism relationships.

Methods: A retrospective analysis was conducted on 62 male players with ACL injuries from three-year professional amateur football tournaments in Dhaka Division, Bangladesh (2022-2025). Data included injury timing (<60, 60–80, >80 minutes), mechanism (change of direction, landing after jump, direct contact/tackle), player position, age, meniscus injury, playing surface, and footwear. Chi-square tests assessed associations (p<0.05).

Results: Of 62 injuries, 58.1% occurred after 80 minutes, 22.6% between 60–80 minutes, and 19.4% before 60 minutes. Mechanisms were direct contact/tackle (61.3%), change of direction (22.6%), and landing after jump (16.1%). Midfielders (38.7%) and defenders (29.0%) sustained the most injuries. Late-game injuries dominated change of direction (85.7%) and direct contact (47.4%) mechanisms. Meniscus injuries accompanied 41.9% of cases, with 100% of landing injuries involving meniscal damage. Most injuries occurred on uneven grass (64.5%), with varied footwear use. Significant associations were found between timing and mechanism (c²=12.45, df=4, p=0.014), timing and surface (c²=9.87, df=4, p=0.043), timing and position (c²=10.32, df=6, p=0.035), and mechanism and position (c²=13.87, df=6, p=0.008).

Conclusion: Late-game ACL injuries, especially non-contact types, are fatigue-related, with midfielders at highest risk for change of direction injuries. Uneven surfaces and improper footwear amplify risk. Position-specific prevention—targeting fatigue, field quality, and footwear standardization-is recommended.

J Dhaka Med Coll. 2025; 34(2) : 119-126