{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:27:26Z","timestamp":1791890846393,"version":"4.3.4"},"reference-count":33,"publisher":"BMJ","issue":"15","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2016,11,28]]},"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The mechanisms of ACL injury in rugby are not well defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To describe the mechanisms of ACL injury in male professional rugby players using systematic video analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>36 cases from games played in top professional leagues and international matches were analysed. 5 analysts independently assessed all videos to record the estimated frame\/time of initial ground contact, frame\/time of ACL tear and a range of play specific variables. This included contact versus non-contact ACL injuries, injury timing, joint flexion angles and foot contact with the ground. 37 side-stepping manoeuvres from a control game were analysed to allow comparison of non-injury versus injury situations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>57% of ACL injuries occurred in a contact manner. 2 main scenarios were identified: (1) offensive running and (2) being tackled, indicating that the ball carrier might be at higher risk of ACL injury. The majority of non-contact ACL injuries resulted from a side-stepping manoeuvre. In most non-contact cases, initial ground contact was through heel strike. Statistical assessment of heel strike at initial ground contact versus non-heel strike cases showed a significant difference in injury versus non-injury outcomes, with heel strike associated with higher injury risk. Non-contact ACL injuries had lower median knee flexion angles and a more dorsiflexed ankle when compared with a control group (10\u00b0 vs 20\u00b0, p\u22640.001 and 10\u00b0 vs 0\u00b0, p=0.033 respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over half of ACL injuries in rugby in our analysis resulted from a contact mechanism. For non-contact injuries, lower knee flexion angles and heel-first ground contact in a side-stepping manoeuvre were associated with ACL injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2016-096425","type":"journal-article","created":{"date-parts":[[2016,12,30]],"date-time":"2016-12-30T21:50:32Z","timestamp":1483134632000},"page":"994-1001","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":141,"title":["Mechanisms of ACL injury in professional rugby union: a systematic video analysis of 36 cases"],"prefix":"10.1136","volume":"52","author":[{"given":"Connor","family":"Montgomery","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Blackburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Withers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4666-4473","authenticated-orcid":false,"given":"Gregory","family":"Tierney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathal","family":"Moran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciaran","family":"Simms","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,12,30]]},"reference":[{"key":"2024051411272049000_52.15.994.1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.36.4.265"},{"key":"2024051411272049000_52.15.994.2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2004.016402"},{"key":"2024051411272049000_52.15.994.3","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2008.047035"},{"key":"2024051411272049000_52.15.994.4","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-091155"},{"key":"2024051411272049000_52.15.994.5","first-page":"45","article-title":"A high rate of injury during the 1995 Rugby World Cup","volume":"88","author":"Jakoet","year":"1998","journal-title":"S Afr Med J"},{"key":"2024051411272049000_52.15.994.6","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506296738"},{"key":"2024051411272049000_52.15.994.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.018341"},{"key":"2024051411272049000_52.15.994.8","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-199214020-00002"},{"key":"2024051411272049000_52.15.994.9","doi-asserted-by":"crossref","first-page":"520","DOI":"10.5435\/00124635-201009000-00003","article-title":"Noncontact anterior cruciate ligament injuries: mechanisms and risk factors","volume":"18","author":"Boden","year":"2010","journal-title":"J American Acad Ortho Surg"},{"key":"2024051411272049000_52.15.994.10","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0b013e318243fb5a"},{"key":"2024051411272049000_52.15.994.11","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0813-1"},{"key":"2024051411272049000_52.15.994.12","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.018358"},{"key":"2024051411272049000_52.15.994.13","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-094573"},{"key":"2024051411272049000_52.15.994.14","doi-asserted-by":"publisher","DOI":"10.1177\/1941738114535184"},{"key":"2024051411272049000_52.15.994.15","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503261724"},{"key":"2024051411272049000_52.15.994.16","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506293899"},{"key":"2024051411272049000_52.15.994.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2006.05.015"},{"key":"2024051411272049000_52.15.994.18","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511405147"},{"key":"2024051411272049000_52.15.994.19","doi-asserted-by":"publisher","DOI":"10.1080\/02640414.2015.1121285"},{"key":"2024051411272049000_52.15.994.20","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.37.3.226"},{"key":"2024051411272049000_52.15.994.21","unstructured":"Cohen J . 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