{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:09:43Z","timestamp":1790737783798,"version":"4.1.0"},"reference-count":34,"publisher":"BMJ","issue":"24","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2024,10,5]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the rates, severity and burden of knee injuries in professional male rugby union from the English Premiership.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Injury and exposure data were captured over 20 seasons using a prospective cohort design. Knee injury incidence, days\u2019 absence and burden were recorded for each injury type and by pitch surface type for match and training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The rate of knee injury in matches was 9.8\/1000\u2009hours (95% CIs 9.3\u201310.3). Mean days lost were 50 (95% CI 46 to 53) in matches and 51 (95% CI 44 to 57) in training. In matches, medial collateral ligament injuries were the most common, while anterior cruciate ligament (ACL) injuries had the highest mean severity and burden. There was no significant change in the count of knee injuries over time; however, average severity increased significantly (annual change: 2.18\u2009days (95% CI 1.60 to 2.77); p&lt;0.001). The incidence of match knee injury was 44% higher on artificial pitches than grass pitches (incidence rate ratio: 1.44 (95% CI 1.21 to 1.69); p&lt;0.01), with no significant difference in severity between surfaces. In matches, the tackle was the event most commonly associated with knee injuries for all diagnoses, except ACL injuries (running). In training, running was a more common injury event than the tackle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Knee injuries in matches are common and severe in English professional men\u2019s rugby union. Despite an increased focus on player conditioning and injury prevention throughout the study period, rates of knee injury remained stable, and resulting days\u2019 absence increased. New strategies for the prevention of knee injuries should be considered a priority.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2024-108639","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T13:20:20Z","timestamp":1729603220000},"page":"1496-1504","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Twenty year analysis of professional men\u2019s rugby union knee injuries from the English premiership shows high rates and burden"],"prefix":"10.1136","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5800-7000","authenticated-orcid":false,"given":"Stephen W","family":"West","sequence":"first","affiliation":[{"name":"Centre for Health, and Injury and Illness Prevention in Sport, University of Bath, Bath, UK"},{"name":"UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK"},{"name":"Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam J","family":"Hudson","sequence":"additional","affiliation":[{"name":"Centre for Health, and Injury and Illness Prevention in Sport, University of Bath, Bath, UK"},{"name":"UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Starling","sequence":"additional","affiliation":[{"name":"Centre for Health, and Injury and Illness Prevention in Sport, University of Bath, Bath, UK"},{"name":"World Rugby, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Cross","sequence":"additional","affiliation":[{"name":"Premiership Rugby, London, UK"},{"name":"Carnegie Applied Rugby Research (CARR) Centre Carnegie Schools of Sport, Leeds Beckett University, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Williams","sequence":"additional","affiliation":[{"name":"Centre for Health, and Injury and Illness Prevention in Sport, University of Bath, Bath, UK"},{"name":"UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly D","family":"McKay","sequence":"additional","affiliation":[{"name":"Centre for Health, and Injury and Illness Prevention in Sport, University of Bath, Bath, UK"},{"name":"UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Cazzola","sequence":"additional","affiliation":[{"name":"Centre for Health, and Injury and Illness Prevention in Sport, University of Bath, Bath, UK"},{"name":"UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2935-7858","authenticated-orcid":false,"given":"John H M","family":"Brooks","sequence":"additional","affiliation":[{"name":"Physiosports, Melbourne, Victoria, Australia"},{"name":"St.Kilda Football Club, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory","family":"Murray","sequence":"additional","affiliation":[{"name":"Bath Rugby, Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Williams","sequence":"additional","affiliation":[{"name":"Fortius Clinic, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3250-2713","authenticated-orcid":false,"given":"Simon P T","family":"Kemp","sequence":"additional","affiliation":[{"name":"Sports Medicine, Rugby Football Union, London, UK"},{"name":"London School of Hygeine and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith A","family":"Stokes","sequence":"additional","affiliation":[{"name":"Centre for Health, and Injury and Illness Prevention in Sport, University of Bath, Bath, UK"},{"name":"UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK"},{"name":"Sports Medicine, Rugby Football Union, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,10,22]]},"reference":[{"key":"2025080115175244000_58.24.1496.1","doi-asserted-by":"publisher","DOI":"10.1080\/02640410801942122"},{"key":"2025080115175244000_58.24.1496.2","doi-asserted-by":"crossref","unstructured":"Williams S , Robertson C , Starling L , et al . 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