Familial Predisposition to Anterior Cruciate Ligament Injury: A Systematic Review with Meta-analysis,Sports Medicine

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Familial Predisposition to Anterior Cruciate Ligament Injury: A Systematic Review with Meta-analysis
Sports Medicine ( IF 9.3 ) Pub Date : 2022-07-12 , DOI: 10.1007/s40279-022-01711-1
Sara Hasani ₁ , Julian A Feller _{1,

2} , Kate E Webster ₁

Affiliation

Background

Having a family history of anterior cruciate ligament (ACL) injury has been investigated in the literature but few studies have focused on this factor specifically or reported their outcomes by sex.

Objective

We aimed to systematically review family history as a risk factor for sustaining a primary ACL injury and the impact it has on ACL graft rupture or contralateral ACL injury in male and female individuals.

Methods

A literature search was completed in seven databases from inception until March 2021 to investigate primary and subsequent ACL injuries in those with a family history of ACL injury. Articles were screened by prespecified inclusion criteria, and the methodological quality of each study was determined. Study results were combined using an odds ratio (OR) meta-analysis. Subgroup analysis was also completed by sex for primary ACL injury, as well as by graft rupture and contralateral ACL injury for subsequent ACL injuries.

Results

Twelve studies were acquired for systematic review and meta-analysis. Four studies that investigated primary ACL injury, seven that investigated ACL graft and/or contralateral ACL ruptures and one study that investigated both primary and subsequent ACL injury. Having a family history of ACL injury increased the odds of injury across all outcomes. Those with a family history had a 2.5 times greater odds for sustaining a primary ACL injury (OR 2.53 [95% confidence interval [CI] 1.96–3.28, p < 0.001)]. There was no significant difference of injury odds for primary ACL injury when analysed by sex. Family history of ACL injury was found to increase the odds of subsequent ACL injury by 2.38 (95% CI 1.64–3.46, p < 0.001) and was significant for both graft ruptures (OR 1.80 [95% CI 1.20–2.71, p = 0.005]) and contralateral ACL injuries (OR 2.28 [95% CI 1.28–4.04, p = 0.005]). When compared directly, the odds of sustaining a graft rupture versus a contralateral ACL injury were similar for those with a family history. Outcomes were not frequently reported by sex for subsequent ACL injuries.

Conclusions

Having a family history of ACL injury more than doubles the odds of sustaining a primary or subsequent ACL injury. However, if a family history of ACL injury is present, the sex of the athlete does not increase the risk for primary injury nor is there a difference in the risk for a subsequent graft rupture compared to a contralateral ACL injury.

Clinical Trial Registration

PROSPERO: CRD42020186472.

中文翻译：

前交叉韧带损伤的家族易感性：荟萃分析的系统评价

背景

文献中已经调查了前交叉韧带 (ACL) 损伤的家族史，但很少有研究专门关注这一因素或按性别报告其结果。

客观的

我们的目的是系统地回顾家族史作为维持原发性 ACL 损伤的危险因素及其对男性和女性个体的 ACL 移植物破裂或对侧 ACL 损伤的影响。

方法

从开始到 2021 年 3 月，在七个数据库中完成了文献检索，以调查具有 ACL 损伤家族史的患者的原发性和后续 ACL 损伤。按照预先指定的纳入标准筛选文章，并确定每项研究的方法学质量。使用比值比 (OR) 荟萃分析合并研究结果。亚组分析还按原发性 ACL 损伤的性别以及随后的 ACL 损伤的移植物断裂和对侧 ACL 损伤完成。

结果

获得了 12 项研究用于系统回顾和荟萃分析。四项研究调查了原发性 ACL 损伤，七项研究调查了 ACL 移植物和/或对侧 ACL 断裂，一项研究调查了原发性和后续 ACL 损伤。有 ACL 损伤家族史会增加所有结果的损伤几率。有家族史的人患原发性 ACL 损伤的几率高出 2.5 倍（OR 2.53 [95% 置信区间 [CI] 1.96–3.28，p < 0.001）]。按性别分析时，原发性 ACL 损伤的损伤几率没有显着差异。发现 ACL 损伤的家族史使后续 ACL 损伤的几率增加 2.38（95% CI 1.64–3.46，p < 0.001) 并且对移植物断裂 (OR 1.80 [95% CI 1.20–2.71, p = 0.005]) 和对侧 ACL 损伤 (OR 2.28 [95% CI 1.28–4.04, p = 0.005]) 均有显着影响。直接比较时，对于有家族史的人来说，移植物破裂与对侧 ACL 损伤的几率相似。随后的 ACL 损伤的结果并不经常按性别报告。