Abstract
BACKGROUND: A clear synthesis of anterior cruciate ligament (ACL) injuries across various sports is lacking. This review aimed to explore the ACL injury across various sports, with focus on the injury mechanism, situational patterns and the circumstances of the ACL injury in articles using video analyses on American football, Australian football, basketball, football (soccer), handball, and rugby. METHODS: A systematic literature search in four databases was conducted in October 2023. English-language articles that analyzed the injury mechanism and situational patterns of ACL injuries through video analysis in American football, Australian football, basketball, football (soccer), handball, and rugby, were considered for inclusion. Data of the injury mechanism, offensive and defensive play, when the injury occurred during the game, the player position, and the horizontal velocity of which the injury occurred were summarized using weighted averages with standard deviation for all, and for respective sports. RESULTS: Twenty-eight articles were included in this scoping review with 1,274 professional athletes, of whom 1,055 (83%) were men. The most common ACL injury mechanism across all sports was non-contact with 43.7%±12.0% of ACL injuries. With regard to game play, the distribution of ACL injuries during offensive versus defensive play was relatively even across all sports (47.2%±20.6% offensive vs. 49.1%±20.9% defensive). Most ACL injuries occurred during the first half across all sports (57.5%±8.9%). The most frequent horizontal velocity at the time of the ACL injury was medium (46.0%±9.9%), corresponding to running, and high to very high velocities (43.4%±18.3%) across all sports. CONCLUSIONS: This scoping review provides an overview of the ACL injury mechanisms, situational patterns, and injury circumstances associated with ACL injuries across multiple sports. By examining the role of contact, type of game play, timing, player position, and horizontal velocity in injury occurrence, this review offers valuable insights for both injury prevention and future research. To understand these factors can inform more effective prevention strategies and help reduce the incidence of ACL injuries in athletes.