Prevention of Non-Contact Anterior Cruciate Ligament Injuries among Youth Female Athletes: An Umbrella Review

Anmol T. Mattu, Brianna Ghali, Vanessa Linton, Alex Zheng and Ian Pike
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Anmol T. Mattu: MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Brianna Ghali: Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
Vanessa Linton: BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC V6H 3V4, Canada
Alex Zheng: BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC V6H 3V4, Canada
Ian Pike: BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC V6H 3V4, Canada

IJERPH, 2022, vol. 19, issue 8, 1-29

Abstract: Anterior cruciate ligament (ACL) injuries account for a large percentage of knee injuries, disproportionately affecting female athletes. To help health professionals stay current, we performed an umbrella review to evaluate the effectiveness of ACL injury prevention programs in reducing non-contact ACL injury rates, determine the effective components within interventions, and provide clinical recommendations. Twelve databases (Medline, Embase, Cochrane Database of Systematic Reviews, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature, PEDro, Web of Science Core Collection, Epistemonikos, TRIP, BC Guidelines and Protocols, CPG Infobase, ProQuest Dissertations and Theses Global) were searched in May 2021 to identify relevant systematic reviews and meta-analyses. Four databases were searched again in September 2021 to identify recent primary literature. Non-contact ACL injury data were extracted to calculate incidence rate ratios (IRRs) and these were combined using an inverse variance random-effects model. A qualitative assessment of included reviews was performed. The methodological quality of the studies was assessed using a Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) or Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2). Sixteen reviews and two primary studies met the inclusion criteria. Across 11 primary studies, prevention programs were effective in reducing non-contact ACL injuries by 64% (IRR = 0.36 (95% CI: 0.18–0.70)). A multi-faceted exercise program, beginning in the pre-season and containing at least three exercise types, may be beneficial in reducing ACL injury risk.

Keywords: anterior cruciate ligament (ACL); female athlete; youth; injury prevention; prevention program; neuromuscular training; meta-analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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