Tackling football's growing injury problem: Expert warns of the risks of osteoarthritis for athletes in later life

Despite the recent success of the England Lionesses in making history to reach the World Cup Final in Australia, the injury problems that plagued the side were well documented, ACL injuries have been particularly prevalent in the women’s game, with concern growing around the reasons for this, causing pivotal players including England caption Leah Williams and Beth Mead ruled out with ACL injury. In the Premier League, Arsenal’s Teyah Goldie has suffered an ACL injury to her right knee, shortly after recovering from the same problem in her left knee.

In fact, a recent report by Sky Sports called “The Future of Football: Why ACL injuries have been on the rise and the solutions and technology to fix it” highlighted that an estimated 195 elite players suffered from an ACL injury in the last 12 months. Football injuries account for nearly half of all ACL reconstructions performed in the UK. They have the highest recovery burden, and account for nearly one-third of all playing time lost due to injury. And, women appear to be 6 times more likely to suffer than men and 25% less likely to return to the sport after injury. 
 

Mark Webb, Consultant Orthopaedic Surgeon at King Edward VII Hospital and St George’s University Hospitals NHS Foundation Trust and pioneer of Arthrosamid® (a novel single hydrogel injection to treat knee osteoarthritis) comments:

“The modern game of football is increasingly fast paced and intense, which requires a demanding training regime, as well as significant physical endurance on match day. This comes alongside new directives for Premier League and EFL Officials to eliminate time-wasting by adding injury time (expected to run into double digit minutes), therefore extending game times which will potentially lead to greater strain on the body, more injuries and greater need for early treatment.

“Historically, footballers have always had relatively high soft tissue, muscle and ligament injury rates, but the current number of both male and female ACL injuries amongst elite footballers is a worrying trend. ACL stands for Anterior Cruciate Ligament. It’s a short, thick, powerful ligament about the length of a little finger that's situated in the knee and attached to our thigh bone and our shin bone. When it tears, or ruptures, it causes devastating injury.

“What’s not talked about enough is the long-term effects of ACL surgery. When the ACL tears, the articular cartilage also gets damaged. This is the tissue that covers the surface of the bone in a joint and allows it to slide smoothly. Regardless of if someone chooses operative or non-operative treatment, they are likely to develop osteoarthritis (OA) at a younger age. ACL surgery aims to provide stability to the knee, reduce the risk of further injury and help people get back to their normal activities. However, studies show 75% of patients who have ACL surgery will have radiographic OA 10-15 years after surgery. So, we need to appreciate that this current crop of injured players will have joint problems further down the line and develop ways to manage these. A young player who goes through surgery for an ACL now, may well be looking at a total knee replacement in their early 40s. Injury prevention – including female-focused strategies – are also crucial in reducing the risk of sustaining this life changing injury. We must also focus on developing ways to delay the onset of osteoarthritis following injury as well as managing the symptoms once OA develops.

Mark Webb, adds:

“We shouldn’t just look at this in term of elite athletes either. Community football is already huge in the UK and with the expected growth of the women’s game at grassroots level already happening following the recent Euro and World Cup performances, as well as the success of England Netball and Women’s Rugby teams, we need to act quickly. The number of ACL injuries we are seeing is already increasing. Prevention strategies need to be followed to help reduce the devastating effect on young people’s lives and livelihoods on the pitch and beyond. Whilst our understanding of the female link with ACL is developing, as experts we do need to close that knowledge gap.”

One positive medical advancement in the treatment of knee osteoarthritis in recent years had been the development of non-invasive alternatives to total knee replacements. Arthrosamid® is an injectable polyacrylamide hydrogel (iPAAG) that becomes embedded in the synovial tissue and can relieve pain in one single treatment. This 15-minute procedure has a 1-2 day recovery period, reducing the need for hospital stays and time off work.

Click here to read patient stories including that of former Olympic swimmer Sharron Davies who is approaching her one year anniversary of treatment for knee osteoarthritis.

Notes:

Using technology pioneered by Contura International Ltd, Arthrosamid® is an injectable polyacrylamide hydrogel (iPAAG) for intra-articular administration. Consisting of 2.5% cross-linked polyacrylamide and 97.5% non-pyrogenic water, a single 6ml dose of Arthrosamid®(2.5 iPAAG) is injected into the joint space, becoming embedded in the synovial membrane¹ and can relieve pain in one single treatment.² Patients can expect to see improved mobility and pain relief within a few weeks².

New data (first released at the Annual Congress of OA Research International, OARSI, in March 2023) highlights impressive 3-year results, showing that a single injection of 6 ml 2.5% polyacrylamide hydrogel, Arthrosamid® continued to be “well-tolerated and demonstrated clinically relevant and statistically significant effectiveness in reducing pain, at 3 years after treatment”.³

To find out more about how Arthrosamid® is improving the quality of life for those suffering from knee osteoarthritis, check out our patient testimonials from both the UK and beyond as well as research highlights and thought leadership content here.

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^References:

^{1. Christensen, L., et al. (2016). Histological Appearance of the Synovial Membrane after Treatment of Knee Osteoarthritis with Polyacrylamide Gel Injections: A Case Report. Journal of Arthritis. Vol 5: 217.}

^{2. Bliddal, H, Overgaard, A, Hartkopp, A et al. (2021) Polyacrylamide Hydrogel Injection for Knee Osteoarthritis: A 6 Months Prospective Study. Journal of Orthopedic Research and Therapy, 6 (2). 1188. ISSN 2575-8241.}

^{3. Henriksen, M. et al. (2023). 3 year results from a prospective study of polyacrylamide hydrogel for knee osteoarthritis. Osteoarthritis and Cartilage, 31(5), P682–683. doi:10.1016/j.joca.2023.02.023.}