School of Allied Health (Physiotherapy), Sport and Exercise Medicine Department, La Trobe University, Bundoora, Victoria, Australia.
Department of Physical Therapies, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia.
Br J Sports Med. 2017 Dec;51(23):1670-1678. doi: 10.1136/bjsports-2017-097500. Epub 2017 Aug 7.
Previous injury is a strong risk factor for recurrent lower limb injury in athletic populations, yet the association between previous injury and a subsequent injury different in nature or location is rarely considered.
To systematically review data on the risk of sustaining a subsequent lower limb injury different in nature or location following a previous injury.
Eight medical databases were searched. Studies were eligible if they reported lower limb injury occurrence following any injury of a different anatomical site and/or of a different nature, assessed injury risk, contained athletic human participants and were written in English. Two reviewers independently applied the eligibility criteria and performed the risk of bias assessment. Meta-analysis was conducted using a random effects model.
Twelve studies satisfied the eligibility criteria. Previous history of an ACL injury was associated with an increased risk of subsequent hamstring injury (three studies, RR=2.25, 95% CI 1.34 to 3.76), but a history of chronic groin injury was not associated with subsequent hamstring injury (three studies, RR=1.14, 95% CI 0.29 to 4.51). Previous lower limb muscular injury was associated with an increased risk of sustaining a lower limb muscular injury at a different site. A history of concussion and a variety of joint injuries were associated with an increased subsequent lower limb injury risk.
The fact that previous injury of any type may increase the risk for a range of lower limb subsequent injuries must be considered in the development of future tertiary prevention programmes.
CRD42016039904 (PROSPERO).
既往损伤是运动人群下肢重复损伤的一个强有力的危险因素，但既往损伤与性质或部位不同的后续损伤之间的关联很少被考虑。
系统回顾既往不同部位或性质损伤后发生性质或部位不同的下肢损伤的风险数据。
8 个医学数据库被检索。如果研究报告了任何不同解剖部位和/或不同性质的损伤后下肢损伤的发生情况，评估了损伤风险，包含运动人群参与者且用英文书写，则符合入选标准。两名审查员独立应用入选标准并进行偏倚风险评估。采用随机效应模型进行荟萃分析。
12 项研究符合入选标准。前交叉韧带损伤史与随后的腘绳肌损伤风险增加相关（3 项研究，RR=2.25，95%CI 1.34 至 3.76），但慢性腹股沟损伤史与随后的腘绳肌损伤无关（3 项研究，RR=1.14，95%CI 0.29 至 4.51）。既往下肢肌肉损伤与不同部位的下肢肌肉损伤风险增加相关。脑震荡史和各种关节损伤与随后下肢损伤风险增加相关。
任何类型的既往损伤都可能增加发生一系列不同类型下肢损伤的风险，这一事实必须在未来的三级预防方案制定中加以考虑。
CRD42016039904（PROSPERO）。
