{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:06:42Z","timestamp":1790698002590,"version":"4.1.0"},"reference-count":60,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpuse<\/jats:title>\n                    <jats:p>To evaluate how playing position affects anterior cruciate ligament (ACL) injury features, incidence rates and career outcomes across competition levels in male football.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the prospectively collected \u2018ACL Registry in German Football\u2019, we analysed six seasons (2016\u20132022) across professional (first to third leagues), semi\u2010professional (fourth to sixth) and amateur (seventh) levels. In professional players, return\u2010to\u2010performance over five seasons was evaluated with linear mixed\u2010effects models, and career outcomes within three seasons after injury were assessed. Injury mechanisms were examined across all levels. Outcomes were stratified by position (goalkeeper [GK], defender [DF], midfielder [MF], forward [FW]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 742 ACL injuries were analysed (professional\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009172, semi\u2010professional\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009316, amateur\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009254). Among professionals, FWs showed the highest rate of a drop in competitive level (47.5%), and GKs a numerically higher rate (54.5%); however, the GK comparison was not statistically significant after correction for multiple testing and should be regarded as exploratory. Mixed\u2010effects models for matches and minutes played showed significant main effects for time and position (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) but no significant interaction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.064 matches;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.105\u2009min). Match\u2010related incidence was highest in DFs (0.397\/1000 player\u2010hours) and MFs (0.370). Injury mechanisms varied by level; direct contact accounted for 66.7% and 46.2% in professional FWs and DFs, respectively, whereas non\u2010contact injuries predominated across all positions in amateur players.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The characteristics and outcomes of ACL injuries may vary by position. Match\u2010related injury rates tended to be highest for DFs and MFs, while career\u2010altering effects appeared most pronounced in FWs, with an exploratory, non\u2010significant tendency also for GKs. Injury rate and consequence should be considered separately. Although non\u2010contact injuries are most common overall, direct contact injuries were relatively frequent among professional FWs and DFs. Prevention and rehabilitation strategies could be tailored to each position.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, prospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70566","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:16:29Z","timestamp":1785770189000},"page":"3794-3806","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of playing position on ACL injury characteristics, risk and career outcomes in football\u2014An analysis of 742 cases of the anterior cruciate ligament registry in German football"],"prefix":"10.1002","volume":"34","author":[{"given":"Shoichi","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Department of Joint Surgery and Sports Medicine Graduate School of Medical and Dental Sciences, Institute of Science Tokyo Tokyo Japan"},{"name":"Sporthopaedicum Straubing Straubing Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Krutsch","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery University Medical Centre Regensburg Regensburg Germany"},{"name":"FIFA Medical Centre of Excellence University Medical Centre Regensburg Regensburg Germany"},{"name":"SportDocs Franken Nueremberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidejuki","family":"Koga","sequence":"additional","affiliation":[{"name":"Department of Joint Surgery and Sports Medicine Graduate School of Medical and Dental Sciences, Institute of Science Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Alt","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery University Medical Centre Regensburg Regensburg Germany"},{"name":"FIFA Medical Centre of Excellence University Medical Centre Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1739-8524","authenticated-orcid":false,"given":"Dominik","family":"Szymski","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery University Medical Centre Regensburg Regensburg Germany"},{"name":"FIFA Medical Centre of Excellence University Medical Centre Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenz","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery University Medical Centre Regensburg Regensburg Germany"},{"name":"FIFA Medical Centre of Excellence University Medical Centre Regensburg Regensburg 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