Since very little evidence was found for a primary non-contact anterior cruciate ligament injury, I wonder if the neuromuscular component is more important during the rehabilitation process to reduce risk of re-injury after return to sport?
It seems that the current programs to reduce risk of knee injuries tend to reduce the risk. The first program that comes to mind is the PEP program. There is another program, but the name of it alludes my brain.
I wonder if there would be different findings if asking the same question but focused on a different target population.
Here's a quick view of the abstract.
The aim of this systematic review was (i) to identify neuromuscular markers that have been predictive of a primary non-contact ACL injury, (ii) to assess whether proposed risk factors have been supported or refuted in the literature from cohort and case-control studies, and (iii) to reflect on the body of research that aims at developing field based tools to assess risk through an association with these risk factors. Electronic searches were undertaken, of PubMed, SCOPUS, Web of Science, CINAHL and SPORTDiscus examining neuromuscular risk factors associated with ACL injury published between January 1990 and July 2015. The evidence supporting neuromuscular risk factors of ACL injury is limited where only 4 prospective cohort studies were found. Three of which looked into muscular capacity and one looked into muscular activation patterns but none of the studies found strong evidence of how muscular capacity or muscular activation deficits are a risk factor for a primary non-contact ACL injury. A number of factors associated to neural control and muscular capacity have been suggested to be related to non-contact ACL injury risk but the level of evidence supporting these risk factors remains often elusive, leaving researchers and practitioners uncertain when developing evidence-based injury prevention programs.
Phys Ther Sport. 2016 Nov;22:101-113. doi: 10.1016/j.ptsp.2016.06.004. Epub 2016 Jun 15.