Anterior cruciate ligament injury incidence in male and female soccer players: A longitudinal study over six consecutive seasons.

Purpose: The aim of this study was to describe the anterior cruciate ligament (ACL) injury incidence differences depending on sex and age-related categories in a large cohort of soccer players over six consecutive seasons.

Methods: This study was designed as a retrospective descriptive epidemiological study. All soccer players in a specific geographical area who sustained an ACL injury across six consecutive seasons were included in this analysis. ACL injury incidence was calculated by sex and age-related category as a percentage of all registered soccer players in the region. Additionally, soccer participation evolution, ACL injury incidence evolution, and monthly ACL injury distribution were studied. Group, seasonal, and monthly differences were analysed using chi-square tests.

Results: Between the 2016-2017 and the 2021-2022 seasons, 3381 ACL injuries were registered from a total of 782,856 player-seasons. ACL injury incidence was 0.43%. Female soccer players showed 2.79 times higher injury incidence than male players, with overall rates of 1.06% in females and 0.38% in males (p < 0.001). However, female players only showed higher ACL injury incidence than males in age groups older than 14 years. ACL injury incidence increased over the six seasons studied only in the male group. October and January were the months with the highest number of ACL injuries, with no significant differences in monthly distribution between sexes.

Conclusions: Female soccer players showed higher ACL injury incidence than males, particularly in age groups older than 14 years. October and January were identified as the months with the highest injury incidences regardless of sex. Additionally, a rising injury incidence was observed in male players, a trend not seen in females.

Level of evidence: Level III, retrospective comparative study.