Objective To evaluate the effectiveness of interventions to prevent and manage knee injuries in runners. Design Systematic review and meta-analysis. Data sources MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus up to May 2022. Eligibility criteria for selecting studies Randomised controlled trials (RCTs) with a primary aim of evaluating the effectiveness of intervention(s) to prevent or manage running-related knee injury. Results Thirty RCTs (18 prevention, 12 management) analysed multiple interventions in novice and recreational running populations. Low-certainty evidence (one trial, 320 participants) indicated that running technique retraining (to land softer) reduced the risk of knee injury compared with control treadmill running (risk ratio (RR) 0.32, 95% CI 0.16 to 0.63). Very low-certainty to low-certainty evidence from 17 other prevention trials (participant range: 24 –3287) indicated that various footwear options, multicomponent exercise therapy, graduated running programmes and online and in person injury prevention education programmes did not influence knee injury risk (RR range: 0.55–1.06). In runners with patellofemoral pain, very low-certainty to low-certainty evidence indicated that running technique retraining strategies, medial-wedged foot orthoses, multicomponent exercise therapy and osteopathic manipulation can reduce knee pain in the short-term (standardised mean difference range: −4.96 to −0.90). Conclusion There is low-certainty evidence that running technique retraining to land softer may reduce knee injury risk by two-thirds. Very low-certainty to low-certainty evidence suggests that running-related patellofemoral pain may be effectively managed through a variety of active (eg, running technique retraining, multicomponent exercise therapy) and passive interventions (eg, foot orthoses, osteopathic manipulation). PROSPERO registration number CRD42020150630

中文翻译：

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预防和管理与跑步相关的膝关节损伤的策略：随机对照试验的系统评价

目的评估干预措施预防和管理跑步者膝关节损伤的有效性。设计系统回顾和荟萃分析。数据来源 MEDLINE、EMBASE、CINAHL、Web of Science 和 SPORTDiscus，截至 2022 年 5 月。 选择研究的资格标准 随机对照试验 (RCT)，主要目的是评估干预措施预防或管理跑步相关膝关节的有效性受伤。结果 30 项 RCT（18 项预防，12 项管理）分析了新手和休闲跑步人群的多种干预措施。低质量证据（一项试验，320 名参与者）表明，与对照跑步机跑步相比，跑步技术再训练（以更柔软地着地）降低了膝关节损伤的风险（风险比 (RR) 0.32，95% CI 0.16 至 0.63）。来自其他 17 项预防试验（参与者范围：24 – 3287）的极低质量至低质量证据表明，各种鞋类选择、多组分运动疗法、分级跑步计划以及在线和现场伤害预防教育计划不会影响膝关节损伤风险（RR 范围：0.55–1.06）。在患有髌股关节疼痛的跑步者中，极低质量至低质量的证据表明，跑步技术再训练策略、内侧楔形足部矫形器、多组分运动疗法和整骨疗法可以在短期内减轻膝关节疼痛（标准化平均差范围：- 4.96 至 -0.90）。结论 低质量证据表明，通过跑步技术再训练以更柔软地着地可以将膝关节损伤风险降低三分之二。非常低质量至低质量的证据表明，与跑步相关的髌股关节疼痛可以通过各种主动（例如，跑步技术再训练、多组分运动疗法）和被动干预（例如，足矫形器、整骨疗法）得到有效管理。PROSPERO 注册号 CRD42020150630