Publication:

The role of jumping and landing patterns in anterior cruciate ligament injury risk: a systematic review of assessment methods

Anterior cruciate ligament (ACL) injuries are a major concern in orthopaedic and sports medicine, with non-contact mechanisms accounting for the majority of cases. Faulty jump-landing biomechanics, including altered joint kinematics and neuromuscular deficits, have been identified as key modifiable risk factors. This systematic review aimed to evaluate the role of jumping and landing patterns in ACL injury risk and to assess the effectiveness of biomechanical assessment tools and preventive interventions. A systematic review was conducted in accordance with PRISMA guidelines. Electronic databases, including PubMed, ScienceDirect, and ClinicalTrials.gov, were searched up to October 2024. Studies involving adults (≥18 years) that assessed jump-landing biomechanics using validated tools such as three-dimensional motion analysis, electromyography, and force plates were included. A total of 120 studies were identified, of which 15 met the inclusion criteria. Data extraction and quality assessment were performed using a structured framework and the Critical appraisal skills programme checklist. Fifteen studies were included, encompassing various study designs and populations. The most consistent biomechanical risk factors identified were increased knee valgus, reduced knee flexion, and poor trunk stability during landing. Fatigue was found to exacerbate these deficits, leading to compromised neuromuscular control. Assessment tools such as motion analysis, electromyography, and force plates effectively identified these risk patterns. Preventive interventions, particularly neuromuscular and plyometric training, demonstrated significant improvements in landing mechanics and reduction in injury risk. Jump-landing biomechanics play a critical role in ACL injury risk. Identification of modifiable risk factors through validated assessment tools allows targeted preventive strategies. Neuromuscular training programs are effective in improving biomechanics and reducing injury incidence; however, broader clinical implementation and long-term adherence remain challenges.