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Background: There is a lack of evidence regarding injury incidence in German elite youth football academies, and the risk of re-injury is unknown. Therefore, the objectives of this study were (1) to determine injury patterns and incidence in an elite youth football academy in Germany, (2) to monitor overuse-/trauma-related injuries over the course of the season, and (3) determine the risk of re-injury., Methods: A prospective cohort study was conducted in the 2012/2013 season among 138 male players from an elite youth football academy in Germany. Injuries were recorded according to the consensus statement on injury definitions and data collection in studies of football injuries. Injury incidence was reported as the number of injuries per 1000 h of exposure and the number of injuries per squad season., Results: A total of 109 injuries were reported, resulting in a cumulative time-loss of 2536 days. A squad of 25 players sustained 19.7 injuries per season, with an average of 23.3 days (15.7-30.9; 95% CI lower-upper) of absence per injury. Ligament sprains (28%), muscle strains (19%) and physeal injuries (12%) were the most common causes of time-loss. Physeal injuries were the most common severe type of injury (29%), with a mean time-loss of 29.7 days (18.2-41.2; 95% CI lower-upper). Re-injuries accounted for 3% of all injuries and resulted in significantly more time-loss than non-re-injuries (60 vs. 23 days; p = 0.01)., Conclusion: In the youth academies studied, a team of 25 players sustained an average of 19.7 injuries per season, resulting in a cumulative time-loss of 459 days. Physeal injuries are a major contributor to severe injuries and therefore require special attention.

Research on the long-term outcomes following surgical therapy for osteochondritis dissecans (OCD) of the knee is scarce. A single-center retrospective cohort study was conducted to investigate surgically treated patients for knee OCD between 1993 and 2007. A total of 37 patients with an average follow-up duration of 14 years (range 8-18) were in the final cohort. IKDC and Lysholm scores were assessed. The duration and types of sport activity were reported. Long-term results were compared with existing midterm data. Knee scores showed a very good outcome with a mean of 91.3 in the IKDC score and 91.7 in the Lysholm score. Compared to midterm outcomes, both IKDC ( p = 0.028) and Lysholm scores ( p = 0.01) improved on final follow-up. Patients with open physes showed a significantly better Lysholm score compared to patients with closed physes ( p = 0.034). Defect localization and size did not influence the outcome, but a defect depth of <0.8 cm 2 achieved significantly better scores than ≥0.8 cm 2 . Of all surgical interventions, refixation achieved the best outcome. Long-term results significantly improved compared to midterm results with a follow-up of 40 months ( p = 0.01). Thirty-six out of 37 patients were physically active, with 56% of sports being knee-straining activities. Long-term results following surgically treated OCD fragments show excellent function and a good athletic level. Patients with open physes potentially have better knee outcomes. Midterm results are sustainable and could improve further in the long term.

Background: Several interventions are established for treating patellofemoral instability in adults. Fewer exist for pediatric patients without damaging the epiphysis. The Ali Krogius (AK) method is currently still being used. Most studies are not current and report varying results in small patient population. The aim of this study is to determine the long-term results of the AK method., Methods: In this monocentric, retrospective study design, 33 knees in 33 patients who received the AK procedure for recurrent patellar dislocation were assessed. The average age was 20.8 years (range 6-40). The following functional scores were assessed: Kujala Score, Lysholm Score and Tegner Score. Subgroup analysis was done for patients ≤16 years of age. Available preoperative imaging was assessed for known risk factors., Results: After an average follow-up of 7.8 years (Range 59-145 months), a total of 8 (24%) knees suffered a redislocation postoperatively. Seven of the eight dislocations occurred in patients ≤ 16 years of age. One knee (3%) was revised due to persistent pain. The median score was 86 points for the Kujala score and 90 for the Lysholm score. The median in the Tegner score was level 6. Clinically, the patellar glide was lateralized in 7 knees (21%) and an apprehension sign was triggered in 8 knees (24%)., Conclusions: Including the present study, the existing literature indicates a redislocation rate between 24 and 41% following AK. It should thus be regarded as obsolete even though it protects the epiphysis. Surgical interventions such as medial patellofemoral ligament reconstruction with femoral drilling distal to the epiphysis should be preferred., Trial Registration: Retrospectively registered: S-302/2016., Level of Evidence: III., (© 2022. The Author(s).)