PT  - JOURNAL ARTICLE
AU  - Liam A Toohey
AU  - Michael K Drew
AU  - Jill L Cook
AU  - Caroline F Finch
AU  - Jamie E Gaida
TI  - Is subsequent lower limb injury associated with previous injury? A systematic review and meta-analysis
AID  - 10.1136/bjsports-2017-097500
DP  - 2017 Dec 01
TA  - British Journal of Sports Medicine
PG  - 1670--1678
VI  - 51
IP  - 23
4099  - http://bjsm.bmj.com/content/51/23/1670.short
4100  - http://bjsm.bmj.com/content/51/23/1670.full
SO  - Br J Sports Med2017 Dec 01; 51
AB  - 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.Systematic review registration number CRD42016039904 (PROSPERO).