Is subsequent lower limb injury associated with previous injury?

A systematic review and meta-analysis

Liam A Toohey, Michael K Drew, Jill L Cook, Caroline F Finch, Jamie E Gaida

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background 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.
Objective To systematically review data on the risk of
sustaining a subsequent lower limb injury different in
nature or location following a previous injury.
Methods 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.
Results 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.
Conclusions 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.
Original languageEnglish
Pages (from-to)1670-1678
Number of pages9
JournalBritish Journal of Sports Medicine
Volume51
Issue number3
Early online date7 Aug 2017
DOIs
Publication statusPublished - 2017

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Meta-Analysis
Lower Extremity
Wounds and Injuries
History
Tertiary Prevention
Athletic Injuries
Groin
Sports
Joints
Databases

Cite this

Toohey, Liam A ; Drew, Michael K ; Cook, Jill L ; Finch, Caroline F ; Gaida, Jamie E. / Is subsequent lower limb injury associated with previous injury? A systematic review and meta-analysis. In: British Journal of Sports Medicine. 2017 ; Vol. 51, No. 3. pp. 1670-1678.
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abstract = "Background Previous injury is a strong risk factor forrecurrent lower limb injury in athletic populations, yet theassociation between previous injury and a subsequentinjury different in nature or location is rarely considered.Objective To systematically review data on the risk ofsustaining a subsequent lower limb injury different innature or location following a previous injury.Methods Eight medical databases were searched.Studies were eligible if they reported lower limbinjury occurrence following any injury of a differentanatomical site and/or of a different nature, assessedinjury risk, contained athletic human participants andwere written in English. Two reviewers independentlyapplied the eligibility criteria and performed the risk ofbias assessment. Meta-analysis was conducted using arandom effects model.Results Twelve studies satisfied the eligibility criteria.Previous history of an ACL injury was associated withan increased risk of subsequent hamstring injury (threestudies, RR=2.25, 95{\%}CI 1.34 to 3.76), but a history ofchronic groin injury was not associated with subsequenthamstring injury (three studies, RR=1.14, 95{\%}CI 0.29to 4.51). Previous lower limb muscular injury wasassociated with an increased risk of sustaining a lowerlimb muscular injury at a different site. A history ofconcussion and a variety of joint injuries were associatedwith an increased subsequent lower limb injury risk.Conclusions The fact that previous injury of anytype may increase the risk for a range of lowerlimb subsequent injuries must be considered in thedevelopment of future tertiary prevention programmes.",
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Is subsequent lower limb injury associated with previous injury? A systematic review and meta-analysis. / Toohey, Liam A; Drew, Michael K; Cook, Jill L; Finch, Caroline F; Gaida, Jamie E.

In: British Journal of Sports Medicine, Vol. 51, No. 3, 2017, p. 1670-1678.

Research output: Contribution to journalArticle

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N2 - Background Previous injury is a strong risk factor forrecurrent lower limb injury in athletic populations, yet theassociation between previous injury and a subsequentinjury different in nature or location is rarely considered.Objective To systematically review data on the risk ofsustaining a subsequent lower limb injury different innature or location following a previous injury.Methods Eight medical databases were searched.Studies were eligible if they reported lower limbinjury occurrence following any injury of a differentanatomical site and/or of a different nature, assessedinjury risk, contained athletic human participants andwere written in English. Two reviewers independentlyapplied the eligibility criteria and performed the risk ofbias assessment. Meta-analysis was conducted using arandom effects model.Results Twelve studies satisfied the eligibility criteria.Previous history of an ACL injury was associated withan increased risk of subsequent hamstring injury (threestudies, RR=2.25, 95%CI 1.34 to 3.76), but a history ofchronic groin injury was not associated with subsequenthamstring injury (three studies, RR=1.14, 95%CI 0.29to 4.51). Previous lower limb muscular injury wasassociated with an increased risk of sustaining a lowerlimb muscular injury at a different site. A history ofconcussion and a variety of joint injuries were associatedwith an increased subsequent lower limb injury risk.Conclusions The fact that previous injury of anytype may increase the risk for a range of lowerlimb subsequent injuries must be considered in thedevelopment of future tertiary prevention programmes.

AB - Background Previous injury is a strong risk factor forrecurrent lower limb injury in athletic populations, yet theassociation between previous injury and a subsequentinjury different in nature or location is rarely considered.Objective To systematically review data on the risk ofsustaining a subsequent lower limb injury different innature or location following a previous injury.Methods Eight medical databases were searched.Studies were eligible if they reported lower limbinjury occurrence following any injury of a differentanatomical site and/or of a different nature, assessedinjury risk, contained athletic human participants andwere written in English. Two reviewers independentlyapplied the eligibility criteria and performed the risk ofbias assessment. Meta-analysis was conducted using arandom effects model.Results Twelve studies satisfied the eligibility criteria.Previous history of an ACL injury was associated withan increased risk of subsequent hamstring injury (threestudies, RR=2.25, 95%CI 1.34 to 3.76), but a history ofchronic groin injury was not associated with subsequenthamstring injury (three studies, RR=1.14, 95%CI 0.29to 4.51). Previous lower limb muscular injury wasassociated with an increased risk of sustaining a lowerlimb muscular injury at a different site. A history ofconcussion and a variety of joint injuries were associatedwith an increased subsequent lower limb injury risk.Conclusions The fact that previous injury of anytype may increase the risk for a range of lowerlimb subsequent injuries must be considered in thedevelopment of future tertiary prevention programmes.

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