Evaluating the effectiveness of preventive training programs in reducing the incidence of knee injuries: a systematic review and meta-analysis

Introduction Knee injuries are highly prevalent among athletes. Following a knee injury, athletes may experience minor disruptions to their competition and training schedules, or in severe cases, the injury may even jeopardize their athletic careers. Incorporating targeted knee injury prevention training into routine training is thus critical for mitigating knee injury risk. Aim This meta-analysis aimed to investigated whether exercise-based preventive training influences the incidence of knee injuries in athletes. Exploratory and prespecified subgroup analyses were concurrently performed to identify potential factors influencing the effectiveness of preventive training programs. Method This study adopted a systematic review and meta-analysis design. A systematic literature search was performed across four electronic databases: PubMed, Embase, Web of Science, and Cochrane Library. The main search terms included “Athletes,” “Knee Injuries,” “Prevention and Control,” and “Random Allocation.” Results A total of 10 studies, involving 15,296 participants, were included in this meta - analysis. The groups that received preventive training showed a significantly lower incidence of knee injuries (overall; RR = 0.68, 95% CI: 0.51–0.92, p = 0.011) and anterior cruciate ligament injuries (RR = 0.43, 95% CI: 0.25–0.74, p = 0.002). Subgroup analysis also revealed several group differences; however, these findings should be interpreted with caution due to the small sample size. The overall heterogeneity of the results was high, and the sources of heterogeneity could not be identified. Conclusion Exercise-based injury-prevention training (such as strength, balance, and plyometric training) can reduce the incidence of knee injuries. Systematic review registration number PROSPERO (registration no. CRD42024543884).