Objective: This Systematic Review aims is to gather the available evidence for Anterior Cruciate Ligament (ACL) injury risk assessment using only biomechanical factors in a clinician-friendly way.

 

Design: Systematic literature review.

 

Data sources: The search was conducted on Pubmed and SCOPUS from January 1, 2008, to October 24, 2022, using the following string query “anterior cruciate ligament injur*” AND (“risk” OR “assessment”) on October 24, 2022.

 

Eligibility criteria for selecting studies: Studies that used only biomechanical factors to assess ACL injury risk in a clinically feasible way or studies that tested the reliability and validity of alternative methods on biomechanical factors that can predict ACL injury risk described in the literature and applicable in the clinical field based. Only studies with a population of athletes or physically active people were included.

 

Results: The Landing Error Scoring System (LESS) predictive value for ACL injury cannot be confirmed considering today’s evidence. The side-to-side differences in anterior-posterior knee displacement and knee hyperextension have shown to predict ACL injury in women athletes. The alternative methods included in this review like 2D motion analysis, Microsoft Xbox One Kinect, and Inertial Measurement Units (IMUs), show good validity and reliability compared to the gold-standard 3D movement analysis.

 

Conclusion: Some studies confirm the effectiveness of low-cost cameras and sensors, some try to validate the LESS score an indicator of ACL injury. The evaluation of Joint Laxity has also been shown to be an excellent way to evaluate the risk of ACL injury on women athletes. However, we still lack a quick and affordable tool for assessing ACL injury risk.

 

Keywords: Injury Risk; Anterior Cruciate Ligament Injury; Injury Prevention; Sport Injury; Movement Screen