Cartilage Issues in Football (Soccer): An Executive Summary of the Fédération Internationale de Football Association (FIFA)/ International Cartilage Repair Society (ICRS) Initiative.

Abstract

The game of football, as it is called worldwide, is played by more than 300 million people globally. It is the most popular sport in the world, and participation in this dynamic sport is growing rapidly. We will from this point forward refer to the football athlete as a football (soccer) player for the importance of convention. The inherent nature of the game is played at the extremes of intense performance and at times is a high-impact contact sport associated with significant acute and chronic joint contact forces with potential detrimental effects to the joint surface. Articular cartilage injury is observed with increasing frequency in football players and is commensurate with the competitive level.1,2 Due to the limited spontaneous regeneration of articular cartilage, injuries often lead to significant symptoms under the continued high demands of football, ultimately resulting in a decrease in performance or the inability to play. The Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) and International Cartilage Repair Society (ICRS) recognize the enormous impact of articular cartilage injury for the football (soccer) player.3 This special issue presents a unique collaboration between FIFA and ICRS in an effort to help advance the science and the understanding of articular cartilage injury and degeneration in the football (soccer) player as well as the options for its treatment and prevention. The approach to the athlete always uses the “spectrum of care” paradigm (Figure 1): prevention, performance optimization, injury care, rehabilitation and restoration, return to sport, prevention of reinjury and osteoarthritis, and keeping the aging athlete healthy through exercise. These are the hallmark principles that illuminate the importance of these collaborative relationships. Using the successful FIFA Football for Health programme, including 11+ to prevent injuries and 11 for Health, this special issue provides 11 articles, like the 11 players on the field, that provide a comprehensive overview over the current knowledge of cartilage injury pathophysiology, epidemiology, and etiology and offers a contemporary view at existing management algorithms, developing treatment options, and prevention strategies for this at-risk population. We are so fortunate to have collaborative and consensus contributions from the world’s experts in their respective fields of cartilage repair! Because the majority of present knowledge is in the area of the knee joint, this is our focus.