Prior history of anterior cruciate ligament (ACL) reconstruction is associated with a greater risk of subsequent ACL injury in female collegiate athletes

Risk Factors for Lower Limb Injury in Female Team Field and Court Sports: A Systematic Review, Meta-analysis, and Best Evidence Synthesis

“…Brumitt et al [89] 19.1 (1.1) -College 1 season Any (32) TL Medical Brumitt et al [62] 19.1 (1.1) S,VB,BB,L,+ College 1 season Any (24) TL Medical Brumitt et al [61] 19.1 (1.1) S,BB,VB,L,+ College 1 season Any (17), ankle (12) TL Medical Brumitt et al [64] 19.3 (1.4) S,BB,VB College 1 season Any (73), ACL (7) NC Medical Brumitt et al [44] 19.2 (1.2) S College 1 season Any (36) TL, NC Medical Brumitt et al [43] 18.9 (1.0) VB College 1 season Any (15), ankle (6) TL, NC Medical Brumitt et al [45] 19.2 (1.2) S,VB,+ College 1 season Any ( 19) TL Medical Brumitt et al [63] 19.2 (1.1) S,VB,BB,L,+ College 1 season Any (40), ankle (15) TL NC Medical Cheng et al [46] 14.8 (1.8) S Competitive 5-9 years Any (42) TL Self Chorba et al [90] 19.2 (1.2) S,BB,VB College 1 season Any (19) ALL Medical Clausen et al [66] 15.6 (0.9) a S Recreational 1 season Knee (34) TL Self Devan et al [32] 19.4 (1.3) S,BB,FH College 1 season Knee (9) OU Medical Dingenen et al [68] 20.2 (2.9) S,VB,HB National 1 year Knee (7) TL, NC Medical Dingenen et al [47] 20.8 (3.5) S,VB,HB National 1 year Any (6) TL Medical Dragoo et al [33] 19.5 (1.6) S,BB,VB,FH,L,+ College 4 years ACL (28) ALL Medical Emery et al [91] 14.8 (-) S Competitive 1 season Any (26) TL Medical Faude et al [48] 22.4 (5.0) S National 1 season Any (99), ankle (33), knee (23), ACL (11) TL Medical Goetschius et al [69] 18.1 (1.7) S,BB,VB,FH,L College/H-school 3 years ACL (20) NC Medical Hartley et al [85] 19.8 (1.5) S,BB,VB College 2 years Ankle (21) TL, LIG Medical Herbst et al [34] 12.7 (0.9) BB Middle school 1 season Anterior knee pain (38) PFP Medical Hewett et al [77] 16.1 (1.7) S,BB,VB High school 3 seasons ACL (9) NC Medical Holden et al [80] 12.9 (0.3) BB,FH,GF,+ High school 2 years Anterior knee pain (8) PFP Self Hopper et al [49] 20 Kosaka et al [70] 15.0 (0.0) BB,HB Hi...…”

“…The meta-analyses for ACL injury indicated three significant risk factors [48,64,67,[69][70][71][72][73][74][75][76] and 16 non-significant factors (Figure 4b) [65,67,[69][70][71][72][73][74][75][76][77][78][79]. Significant risk factors for ACL injury included previous ACL injury (OR = 3.94, 95% CI = 2.07 -7.50) [48,64,76], greater postural sway (centre of gravity movement per second) during 30s double-leg balance with eyes open (SMD = 0.58, 95% CI = 0.02 -1.15) [73,74], and greater body mass (SMD = 0.25, 95% CI = 0.12 -0.39) [67,[69][70][71][72][73][74][75][76]. There were no significant risk factors for anterior knee pain (Figure 4c) [80][81][82][83].…”

“…Seventy of these factors contained additional data that were not included in a meta-analysis [89][90][91][92][93][94][95][96][97][98]. The best evidence synthesis found that prior ACL injury had strong evidence for an association with recurrent ACL injury [64,48,94,76], and lower knee injury and osteoarthritis outcome score (KOOS) (e.g. worse knee related symptoms) had moderate evidence for an association with any future knee injury [99,66] Evidence was often conflicting between prospective studies and the majority of factors investigated to date were not associated with lower limb injury risk in female athletes.…”

Screening Tests for Assessing Athletes at Risk of ACL Injury or Reinjury—A Scoping Review

“…The following tests were commonly investigated for a potential association with ACL (re)injury: dynamic knee valgus during drop vertical jump (DVJ) [ 10 , 11 , 12 , 13 , 14 , 35 , 40 , 48 , 57 ], maximal height at DVJ [ 14 , 16 ] and single-leg hop test for distance [ 18 , 30 , 39 ]. Other tests commonly used were the distance of a triple crossover hop [ 60 ], standing long jump [ 30 , 54 ] and jumping single-legged backwards, forwards, medially and laterally onto a force platform [ 34 ]. Furthermore, a jump coordination test for speed, counter movement jump for height and specific counter movement jump for height with restricted ankles were reported [ 16 ].…”

“…In 10 studies, at least one association between jump tests and ACL (re)injury was stated [ 10 , 11 , 12 , 14 , 16 , 18 , 34 , 41 , 48 , 49 ]. Another eight did not show any association with ACL (re)injury [ 13 , 30 , 35 , 39 , 40 , 54 , 57 , 60 ]. The main metrics associated with ACL (re)injury were knee abduction moment (KAM) or knee abduction angle (KAA) during DVJ (KAA at landing was 8° greater in ACL-injured than in uninjured athletes; KAA was increased at one knee in twin sisters—sibling 1, −11.3°; sibling 2, −7.7°—versus controls, 24.6° (5.6); dynamic knee valgus was significantly greater in the injured group than in the control group at ground contact (2.1 (2.4) vs. 0.4 (2.2) cm) [ 10 , 14 , 48 ].…”