Humanities
Skip to main content Skip to main navigation menu Skip to site footer
  • Register
  • Login
  • Menu
  • Home
  • Current
  • Archives
  • Announcements
  • About
    • About the Journal
    • Submissions
    • Editorial Team
    • Privacy Statement
    • Contact
  • Register
  • Login

Journal of Education, Health and Sport

Anterior Cruciate Ligament Injuries in Athletes: Risk Factors, Mechanisms, Treatment, and Return-to-Sport Outcomes – A Narrative Review
  • Home
  • /
  • Anterior Cruciate Ligament Injuries in Athletes: Risk Factors, Mechanisms, Treatment, and Return-to-Sport Outcomes – A Narrative Review
  1. Home /
  2. Archives /
  3. Vol. 94 (2026) /
  4. Medical Sciences

Anterior Cruciate Ligament Injuries in Athletes: Risk Factors, Mechanisms, Treatment, and Return-to-Sport Outcomes – A Narrative Review

Authors

  • Krzysztof Bednarski Beskid Oncology Center Municipal Hospital of John Paul II, Bielsko-Biała, Poland https://orcid.org/0009-0000-9801-2832
  • Natalia Kornacka Beskid Oncology Center Municipal Hospital of John Paul II, Bielsko-Biała, Poland https://orcid.org/0009-0003-3657-2027
  • Melania Majewska County Medical Center in Grójec, Poland https://orcid.org/0009-0009-5334-6965
  • Natalia Piasecka University Clinical Center of the Medical University of Warsaw, Poland https://orcid.org/0009-0001-2361-8060
  • Izabela Rafalska Upper Silesian Medical Centre of Prof. Leszek Giec, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0003-1687-8037
  • Jakub Smagoń Upper Silesian Medical Centre of Prof. Leszek Giec, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0008-0109-7349
  • Martyna Kaim District Hospital in Limanowa, Poland https://orcid.org/0009-0001-6818-6732
  • Joanna Bober Provincial Specialist Hospital in Wroclaw, Poland https://orcid.org/0009-0007-0118-885X
  • Magdalena Bochenek Provincial Specialist Hospital in Wroclaw, Poland https://orcid.org/0009-0006-3997-2810
  • Wiktoria Siewiera American Heart of Poland: Ustroń, Silesia, Poland https://orcid.org/0009-0009-1875-0209

DOI:

https://doi.org/10.12775/JEHS.2026.94.72914

Keywords

athletes, anterior cruciate ligament, ACL injury, return to sport, rehabilitation, risk factors

Abstract

Background: Anterior cruciate ligament (ACL) injury is a common and serious injury in athletes, particularly in sports involving pivoting, jumping, and rapid direction changes. ACL rupture may result in knee instability, reduced performance, prolonged absence from sport, and increased risk of osteoarthritis.

Aim: The aim of this study was to summarize current evidence regarding risk factors, treatment, rehabilitation, and return-to-sport outcomes after ACL injury in athletes.

Materials and methods: This narrative review analyzed current literature on ACL injuries in athletes. Studies concerning epidemiology, injury mechanisms, treatment strategies, rehabilitation, and return to sport were identified using PubMed, Scopus, and Google Scholar. English-language publications from 2000–2024 were included.

Results: ACL injury is multifactorial and strongly associated with neuromuscular and biomechanical deficits. Prevention programs focused on neuromuscular training may reduce injury risk. ACL reconstruction combined with structured rehabilitation remains the preferred treatment for many athletes. Criteria-based return-to-sport assessment is increasingly recommended to reduce re-injury risk.

Conclusions: Effective ACL injury management requires prevention, individualized rehabilitation, and evidence-based return-to-sport decisions. Despite advances in treatment, the risk of secondary injury remains significant.

References

1. Griffin LY, Albohm MJ, Arendt EA, et al. Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005. Am J Sports Med. 2006;34(9):1512-1532. doi:10.1177/0363546506286866

2. Beynnon BD, Vacek PM, Newell MK, et al. The effects of level of competition, sport, and sex on the incidence of first-time noncontact ACL injury. Am J Sports Med. 2014;42(8):1806-1812. doi:10.1177/0363546514540862

3. Waldén M, Hägglund M, Magnusson H, Ekstrand J. Anterior cruciate ligament injury in elite football: a prospective three-cohort study. Knee Surg Sports Traumatol Arthrosc. 2011;19(1):11-19. doi:10.1007/s00167-010-1170-9

4. Sanders TL, Maradit Kremers H, Bryan AJ, et al. Incidence of anterior cruciate ligament tears and reconstruction. Am J Sports Med. 2016;44(6):1502-1507. doi:10.1177/0363546516629944

5. Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis. Br J Sports Med. 2011;45(7):596-606. doi:10.1136/bjsm.2010.076364

6. Øiestad BE, Engebretsen L, Storheim K, Risberg MA. Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med. 2009;37(7):1434-1443. doi:10.1177/0363546509338827

7. Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. 2007;35(10):1756-1769. doi:10.1177/0363546507307396

8. Hewett TE, Myer GD, Ford KR. Anterior cruciate ligament injuries in female athletes: part 1, mechanisms and risk factors. Am J Sports Med. 2006;34(2):299-311. doi:10.1177/0363546505284183

9. Shultz SJ, Schmitz RJ, Nguyen AD. ACL Research Retreat V: an update on ACL injury risk and prevention. J Athl Train. 2010;45(5):499-508. doi:10.4085/1062-6050-45.5.499

10. Griffin LY, Agel J, Albohm MJ, et al. Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg. 2000;8(3):141-150. doi:10.5435/00124635-200005000-00001

11. Krosshaug T, Nakamae A, Boden BP, et al. Mechanisms of anterior cruciate ligament injury in basketball: video analysis. Am J Sports Med. 2007;35(3):359-367. doi:10.1177/0363546506293899

12. Hewett TE, Myer GD, Ford KR. Biomechanical measures of neuromuscular control and valgus loading predict ACL injury risk in female athletes. Am J Sports Med. 2005;33(4):492-501. doi:10.1177/0363546504269591

13. Frobell RB, Roos HP, Roos EM, et al. Treatment for acute anterior cruciate ligament tear: randomized controlled trial. N Engl J Med. 2010;363:331-342. doi:10.1056/NEJMoa0907797

14. Kaplan Y, Witvrouw E. When is it safe to return to sport after ACL reconstruction? Reviewing the criteria. Sports Health. 2019;11(4):301-305. doi:10.1177/1941738119846502

15. Ardern CL, Taylor NF, Feller JA, Webster KE. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med. 2014;48(21):1543-1552. doi:10.1136/bjsports-2013-093398

16. Wiggins AJ, Grandhi RK, Schneider DK, et al. Risk of secondary ACL injury in athletes: a systematic review and meta-analysis. Am J Sports Med. 2016;44(7):1861-1876. doi:10.1177/0363546515621554

17. Hashemi J, Chandrashekar N, Gill B, et al. The geometry of the tibial plateau and ACL injury risk. J Bone Joint Surg Am. 2008;90(10):2035-2042. doi:10.2106/JBJS.G.01141

18. Shelbourne KD, Davis TJ, Klootwyk TE. The relationship between intercondylar notch width and ACL injury. Am J Sports Med. 1998;26(3):402-408. doi:10.1177/03635465980260031101

19. Myer GD, Ford KR, Hewett TE. Neuromuscular deficits and ACL injury risk. Clin Orthop Relat Res. 2006;455:138-147. doi:10.1097/01.blo.0000224053.90352.7f

20. Hewett TE, Torg JS, Boden BP. Video analysis of ACL injuries: clinical implications. Am J Sports Med. 2009;37(1):73-79. doi:10.1177/0363546508325669

21. Wojtys EM, Huston LJ, Lindenfeld TN, et al. Association between menstrual cycle and ACL injuries. Am J Sports Med. 1998;26(5):614-619. doi:10.1177/03635465980260050301

22. Posthumus M, September AV, O’Cuinneagain D, et al. Genetic risk factors for ACL ruptures. Br J Sports Med. 2009;43(5):352-357. doi:10.1136/bjsm.2008.056150

23. Orchard J, Seward H. Football injuries and playing surface. Br J Sports Med. 2002;36(2):95-99. doi:10.1136/bjsm.36.2.95

24. McLean SG, Samorezov JE. Fatigue and ACL injury risk. Clin Biomech. 2009;24(7):589-594. doi:10.1016/j.clinbiomech.2009.04.001

25. van Grinsven S, van Cingel REH, Holla CJM, van Loon CJM. Evidence-based rehabilitation following ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010;18(8):1128-1144. doi:10.1007/s00167-009-1027-2

26. Fitzgerald GK, Axe MJ, Snyder-Mackler L. A decision-making scheme for returning patients to sport after ACL injury. J Orthop Sports Phys Ther. 2000;30(4):194-203. doi:10.2519/jospt.2000.30.4.194

27. Xie X, Liu X, Chen Z, et al. A meta-analysis of patellar tendon versus hamstring tendon autografts. Knee. 2015;22(2):100-110. doi:10.1016/j.knee.2014.11.014

28. Desai N, Björnsson H, Musahl V, et al. Anatomic single- versus double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2014;22(5):1009-1023. doi:10.1007/s00167-013-2787-6

29. Adams D, Logerstedt DS, Hunter-Giordano A, et al. Current concepts for ACL rehabilitation. J Orthop Sports Phys Ther. 2012;42(7):601-614. doi:10.2519/jospt.2012.3871

30. Filardo G, Di Matteo B, Kon E, et al. Platelet-rich plasma in tendon-related disorders. Knee Surg Sports Traumatol Arthrosc. 2018;26(7):1984-1999. doi:10.1007/s00167-016-4261-4

31. Grindem H, Snyder-Mackler L, Moksnes H, et al. Simple decision rules can reduce reinjury risk after ACL reconstruction. Br J Sports Med. 2016;50(13):804-808. doi:10.1136/bjsports-2016-096031

32. Kyritsis P, Bahr R, Landreau P, et al. Likelihood of ACL graft rupture and return to sport criteria. Br J Sports Med. 2016;50(15):946-951. doi:10.1136/bjsports-2015-095908

33. Logerstedt D, Grindem H, Lynch A, et al. Single-legged hop tests as predictors of function. Am J Sports Med. 2012;40(10):2348-2356. doi:10.1177/0363546512457551

34. Webster KE, Feller JA, Lambros C. Development and preliminary validation of the ACL-RSI scale. Phys Ther Sport. 2008;9(1):9-15. doi:10.1016/j.ptsp.2007.09.003

35. Paterno MV, Rauh MJ, Schmitt LC, et al. Incidence of second ACL injury after reconstruction. Am J Sports Med. 2014;42(7):1567-1573. doi:10.1177/0363546514530088

Journal of Education, Health and Sport

Downloads

  • PDF

Published

2026-07-17

How to Cite

1.
BEDNARSKI, Krzysztof, KORNACKA, Natalia, MAJEWSKA, Melania, PIASECKA, Natalia, RAFALSKA, Izabela, SMAGOŃ, Jakub, KAIM, Martyna, BOBER, Joanna, BOCHENEK, Magdalena and SIEWIERA, Wiktoria. Anterior Cruciate Ligament Injuries in Athletes: Risk Factors, Mechanisms, Treatment, and Return-to-Sport Outcomes – A Narrative Review. Journal of Education, Health and Sport. Online. 17 July 2026. Vol. 94, p. 72914. [Accessed 25 July 2026]. DOI 10.12775/JEHS.2026.94.72914.
  • ISO 690
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
Download Citation
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

Issue

Vol. 94 (2026)

Section

Medical Sciences

License

Copyright (c) 2026 Krzysztof Bednarski, Natalia Kornacka, Melania Majewska, Natalia Piasecka, Izabela Rafalska, Jakub Smagoń, Martyna Kaim, Joanna Bober, Magdalena Bochenek, Wiktoria Siewiera

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0

Stats

Number of views and downloads: 66
Number of citations: 0

Search

Search

Browse

  • Browse Author Index
  • Issue archive

User

User

Current Issue

  • Atom logo
  • RSS2 logo
  • RSS1 logo

Information

  • For Readers
  • For Authors
  • For Librarians

Newsletter

Subscribe Unsubscribe

Tags

Search using one of provided tags:

athletes, anterior cruciate ligament, ACL injury, return to sport, rehabilitation, risk factors
Up

Akademicka Platforma Czasopism

Najlepsze czasopisma naukowe i akademickie w jednym miejscu

apcz.umk.pl

Partners

  • Akademia Ignatianum w Krakowie
  • Akademickie Towarzystwo Andragogiczne
  • Fundacja Copernicus na rzecz Rozwoju Badań Naukowych
  • Instytut Historii im. Tadeusza Manteuffla Polskiej Akademii Nauk
  • Instytut Kultur Śródziemnomorskich i Orientalnych PAN
  • Instytut Tomistyczny
  • Karmelitański Instytut Duchowości w Krakowie
  • Ministerstwo Kultury i Dziedzictwa Narodowego
  • Państwowa Akademia Nauk Stosowanych w Krośnie
  • Państwowa Akademia Nauk Stosowanych we Włocławku
  • Państwowa Wyższa Szkoła Zawodowa im. Stanisława Pigonia w Krośnie
  • Polska Fundacja Przemysłu Kosmicznego
  • Polskie Towarzystwo Ekonomiczne
  • Polskie Towarzystwo Ludoznawcze
  • Towarzystwo Miłośników Torunia
  • Towarzystwo Naukowe w Toruniu
  • Uniwersytet im. Adama Mickiewicza w Poznaniu
  • Uniwersytet Komisji Edukacji Narodowej w Krakowie
  • Uniwersytet Mikołaja Kopernika
  • Uniwersytet w Białymstoku
  • Uniwersytet Warszawski
  • Wojewódzka Biblioteka Publiczna - Książnica Kopernikańska
  • Wyższe Seminarium Duchowne w Pelplinie / Wydawnictwo Diecezjalne „Bernardinum" w Pelplinie

© 2021- Nicolaus Copernicus University Accessibility statement Shop