Incidence of Anterior Cruciate Ligament Injury and Subgroup Analysis by Age, Sex, Injury Mechanism, and Severity Among Bangladeshi 1853 Soccer Players: A 1‐Year Prospective Cohort Study

ABSTRACT Background and Aims Anterior cruciate ligament (ACL) injuries are a major concern in soccer due to their high incidence and long‐term functional impact. Despite this, there is a lack of prospective epidemiological data on ACL injuries among soccer players. This study aimed to investigate the incidence of ACL injuries among Bangladeshi soccer players during a 1‐year follow‐up period, with subgroup analyses by age, sex, injury mechanism, and severity. Methods A 1‐year prospective study was conducted involving 1853 participants during the 2024–2025 session across 12 soccer clubs in Bangladesh. During follow‐up, all knee‐related injuries were recorded, including associated factors, and the number of ACL injuries was confirmed by magnetic resonance imaging (MRI). Incidence of ACL injury was compared by age group (11–14 years; 15–18 years; 19–22 years; and >22 years), sex (male and female), injury mechanism (contact‐person; contact‐friction; and overuse/non‐contact), and severity (Grade I/II/III; pain intensity—Visual Analog Scale: VAS). Results A total of 110 MRI‐confirmed ACL injuries were recorded, with an overall incidence rate of 0.16 per 1000 exposure hours (95% CI: 0.133–0.195) and a cumulative proportion of 5.94% (95% CI: 4.90–7.11). Incidence increased progressively with age, from 0.05 in 11–14 years to 0.23 in > 22 years ( p < 0.001). Females showed a higher crude incidence than males (0.20 vs. 0.14 per 1000 h; p = 0.041), though this was not significant after adjustment. Contact mechanisms predominated (0.07 player‐to‐player, 0.06 surface‐related) compared with non‐contact injuries (0.03; p = 0.008). By severity, Grade II injuries were most frequent (0.09 per 1000 h). Conclusion This study indicates a higher incidence of ACL injuries among Bangladeshi soccer players, supported by subgroup analyses. It examines key associated factors, including age, sex, injury mechanism, and severity. These findings should be interpreted with caution and not considered definitive. Overall, they may help guide targeted prevention strategies.