Reducing ACL injury risk: A meta-analysis of prevention programme effectiveness.

IF 3.3 2区 医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-11-12 DOI:10.1002/ksa.12542
Clemens Clar, Stefan F Fischerauer, Andreas Leithner, Laura Rasic, Paul Ruckenstuhl, Patrick Sadoghi
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Abstract

Purpose: The aim of this study was to conduct a meta-analysis of the literature regarding anterior cruciate ligament (ACL) injury prevention programmes (IPPs) in order to assess the effectiveness of ACL prevention programmes based on current high-quality studies. The hypothesis was that the implementation of ACL IPPs significantly reduces the incidence of ACL ruptures compared to standard practice.

Methods: A meta-analysis of the literature was conducted using the databases PubMed, EMBASE, MEDLINE, CINHAL and Cochrane Central Register of Controlled Trials. The search terms utilized were ACL, injury, knee, control and prevention. The collected data and reported clinical outcomes were independently gathered by three different individuals. After evaluating the heterogeneity of the studies, the DerSimonian-Laird random effects models were employed to determine the pooled risk ratios (RRs) and the risk differences (RDs) regarding ACL Injuries. The RD was utilized to ascertain the number needed to treat.

Results: The search strategy identified 743 studies, of which 11 met all inclusion and quality criteria for pooled analysis. The total number of study participants was 16,316. The overall RR of sustaining an ACL injury in the intervention group was 0.36 (95% confidence interval [CI]: 0.23 to 0.57) of the control group, showing a significant reduction in the ACL injury risk of the intervention group (p < 0.001). We identified an RD of -1.4% (95% CI: -2.4% to -0.4%) in favour of the intervention group. The number needed to treat in preventing one ACL rupture was 71.

Conclusion: In conclusion, the study clearly demonstrates a significant positive preventive effect of training programmes concerning ACL injuries (p < 0.001). The pooled estimates indicate that such programmes result in a significant reduction of ACL injury risks (p < 0.001). Despite the moderate quality of the included literature, the results exhibit robustness. However, based on the literature examined, no definitive superior training programme could be identified.

Level of evidence: II.

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降低前交叉韧带损伤风险:对预防计划有效性的荟萃分析。
目的:本研究旨在对有关前交叉韧带(ACL)损伤预防计划(IPPs)的文献进行荟萃分析,以便在目前高质量研究的基础上评估前交叉韧带预防计划的有效性。假设与标准做法相比,前交叉韧带损伤预防计划的实施能显著降低前交叉韧带断裂的发生率:使用 PubMed、EMBASE、MEDLINE、CINHAL 和 Cochrane Central Register of Controlled Trials 等数据库对文献进行了荟萃分析。检索词包括前交叉韧带、损伤、膝关节、控制和预防。收集的数据和报告的临床结果由三个不同的人独立收集。在对研究的异质性进行评估后,采用 DerSimonian-Laird 随机效应模型来确定有关前交叉韧带损伤的集合风险比 (RR) 和风险差异 (RD)。RD用于确定需要治疗的人数:搜索策略确定了 743 项研究,其中 11 项符合所有纳入标准和质量标准,可进行汇总分析。参与研究的总人数为 16,316 人。干预组发生前交叉韧带损伤的总RR为对照组的0.36(95%置信区间[CI]:0.23至0.57),表明干预组的前交叉韧带损伤风险显著降低(P 结论:干预组发生前交叉韧带损伤的总RR为对照组的0.36(95%置信区间[CI]:0.23至0.57):总之,该研究清楚地表明,训练计划对预防前交叉韧带损伤具有显著的积极作用(p 证据等级:II.
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来源期刊
CiteScore
8.10
自引率
18.40%
发文量
418
审稿时长
2 months
期刊介绍: Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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