{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:17:07Z","timestamp":1787019427553,"version":"build-2736575974"},"reference-count":25,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The factors associated with anterior cruciate ligament (ACL) injury mechanism in professional American football players are not well-understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>It was hypothesized that football-related and player-specific factors, such as position and body mass index (BMI), are associated with ACL injury mechanism in these athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Descriptive epidemiology study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Videos of ACL tears occurring in National Football League (NFL) games over 6 consecutive seasons from 2014 to 2019 were reviewed by 2 orthopaedic surgeons who specialize in sports medicine. For each injury, the role of contact ( direct contact [contact to the injured knee\/lower extremity], indirect contact [contact not involving the injured knee\/lower extremity], or no contact) as well as playing situation and lower extremity position were recorded. Additional player characteristics, timing of injury, and surface information were obtained from NFL game-day and injury database statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 140 ACL tears, a minority occurred via direct contact to the injured lower extremity (30%), although this varied by position. Just over two-thirds (70%) of ACL tears in offensive linemen occurred via direct contact to the injured lower extremity, while wide receivers had no direct contact ACL tears. Elevated BMI was associated with a greater likelihood of ACL tears occurring via direct contact (53% in players with BMI \u226535 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      vs 24% in players with BMI &lt;35 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; P = &lt;.01). Rookies had the lowest percentage of direct contact ACL tears (18%; P = .22). ACL tears that occurred during the middle 8 weeks of the regular season resulted more often from direct contact (38%; P = .06). ACL tears that occurred in the third quarter were the most likely to occur via direct contact (44%), while those that occurred in the fourth quarter were the least likely to occur via direct contact (13%; P &lt; .01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although most NFL players sustained ACL tears via a noncontact mechanism (ie, through indirect or no contact), players with an elevated BMI, especially on the offensive line, were more likely to injure their ACL through direct contact. Position-dependent variance in injury mechanism may help guide injury prevention efforts in these athletes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671211053301","type":"journal-article","created":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T11:22:27Z","timestamp":1636370547000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Factors Associated With the Mechanism of ACL Tears in the National Football League: A Video-Based Analysis"],"prefix":"10.1177","volume":"9","author":[{"given":"Robert H.","family":"Brophy","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward M.","family":"Wojtys","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, Michigan, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina D.","family":"Mack","sequence":"additional","affiliation":[{"name":"IQVIA, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalyani","family":"Hawaldar","sequence":"additional","affiliation":[{"name":"IQVIA, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mackenzie M.","family":"Herzog","sequence":"additional","affiliation":[{"name":"IQVIA, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett D.","family":"Owens","sequence":"additional","affiliation":[{"name":"Brown University, East Providence, Rhode Island, 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