RESUMEN
BACKGROUND: The purpose of this study was to evaluate with video analysis the circumstances and the mechanism leading to ACL injury in a high-level population of athletes participating in the main European football championships. METHODS: Video analysis of 128 competitive matches with ACL injury events was performed through Wyscout.com® from August 2009 to January 2020. Details regarding situation, events and injured players were obtained. The type of trauma was assessed on the basis of the game phase, player's action, traumatic mechanism, type of maneuver, contact type, speed of the action and the position of the center of gravity. RESULTS: Of the injuries, 67.2% occurred without direct contact (39.1% non-contact and 28.1% indirect contact) and more than 50% occurred in the first 30 minutes of the match; 31.2% of injuries occurred during ball recovery and 63% in the offensive half; 62.5% of the trauma occurred in a valgus-external rotation maneuver and 35.1% during a deceleration phase with an eccentric contraction of the quadriceps. The referee whistled a foul in 20.6% of cases. CONCLUSIONS: Video-analysis may be helpful either to better understand the situations leading to ACL injury or to set up preventive strategies in order to reduce ACL injury in football. Most of the injuries occur during the first thirty minutes after entering the field. It therefore seems unlikely that fatigue will play an important role. Valgus external rotation, eccentric muscular contraction, loss of the center of gravity, attempting to recover the ball are the most frequent scenario.