{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:22:00Z","timestamp":1792120920281,"version":"4.4.0"},"reference-count":46,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2010,7,1]],"date-time":"2010-07-01T00:00:00Z","timestamp":1277942400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:p>Background: Generalized joint hypermobility is a highly prevalent condition commonly associated with joint injuries. The current literature has conflicting reports of the risk of joint injury in hypermobile sporting participants compared with their nonhypermobile peers. Systematic reviews have not been conclusive and no meta-analysis has been performed.<\/jats:p>\n                  <jats:p>Purpose: This review was undertaken to determine whether individuals with generalized joint hypermobility have an increased risk of lower limb joint injury when undertaking sporting activities.<\/jats:p>\n                  <jats:p>Study Design: Systematic review with meta-analysis.<\/jats:p>\n                  <jats:p>Methods: Studies were identified through a search without language restrictions of PubMed, CINAHL, Embase, and SportDiscus databases from the earliest date through February 2009 with subsequent handsearching of reference lists. Inclusion criteria for studies were determined before searching and all included studies underwent methodological quality assessment by 2 independent reviewers. Meta-analyses for joint injury of the lower limb, knee, and ankle were performed using a random effects model. The difference in injury proportions between hypermobility categories was tested with the z statistic.<\/jats:p>\n                  <jats:p>Results: Of 4841 identified studies, 18 met all inclusion criteria with methodological quality ranging from 1 of 6 to 5 of 6. A variety of tests of hypermobility and varied cutoff points to define the presence of generalized joint hypermobility were used, so the authors determined a standardized cutoff to indicate generalized joint hypermobility. Using this criterion, a significantly increased risk of knee joint injury for hypermobile and extremely hypermobile participants compared with their nonhypermobile peers was demonstrated ( P &lt; .001), whereas no increased risk was found for ankle joint injury. For knee joint injury, a combined odds ratio of 4.69 (95% confidence interval, 1.33-16.52; P = .02) was calculated, indicating a significantly increased risk for hypermobile participants playing contact sports.<\/jats:p>\n                  <jats:p>Conclusion: Sport participants with generalized joint hypermobility have an increased risk of knee joint injury during contact activities but have no altered risk of ankle joint injury.<\/jats:p>","DOI":"10.1177\/0363546510364838","type":"journal-article","created":{"date-parts":[[2010,7,2]],"date-time":"2010-07-02T19:57:55Z","timestamp":1278100675000},"page":"1487-1497","source":"Crossref","is-referenced-by-count":167,"title":["Generalized Joint Hypermobility and Risk of Lower Limb Joint Injury During Sport"],"prefix":"10.1177","volume":"38","author":[{"given":"Verity","family":"Pacey","sequence":"first","affiliation":[{"name":"Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Physiotherapy Department"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie L.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger D.","family":"Adams","sequence":"additional","affiliation":[{"name":"Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Munn","sequence":"additional","affiliation":[{"name":"Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig F.","family":"Munns","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"Discipline of Pediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2010,7,2]]},"reference":[{"key":"bibr1-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh557"},{"key":"bibr2-0363546510364838","first-page":"239","volume-title":"Science of Flexibility","author":"Alter MJ","year":"1996"},{"key":"bibr3-0363546510364838","first-page":"234","volume-title":"Practical Statistics for Medical Research","author":"Altman DG","year":"1991"},{"key":"bibr4-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7306.224"},{"key":"bibr5-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1177\/036354659502300508"},{"key":"bibr6-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-0266(00)90004-4"},{"key":"bibr7-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/33.1.56"},{"key":"bibr8-0363546510364838","volume-title":"Clinical Sports Medicine","author":"Brukner P","year":"1993"},{"key":"bibr9-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.6154.1759"},{"key":"bibr10-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2006.029645"},{"key":"bibr11-0363546510364838","first-page":"99","volume":"34","author":"Decoster LC","year":"1999","journal-title":"J Athl Train"},{"key":"bibr12-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"bibr13-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/32.2.120"},{"key":"bibr14-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7506-5390-9.50005-8"},{"key":"bibr15-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1002\/art.20376"},{"key":"bibr16-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e31815f2b35"},{"key":"bibr17-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1080\/02640419508732230"},{"key":"bibr18-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200003000-00007"},{"key":"bibr19-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.060410"},{"key":"bibr20-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780230914"},{"key":"bibr21-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1975.03260240047025"},{"key":"bibr22-0363546510364838","first-page":"692","volume":"11","author":"Klemp P","year":"1984","journal-title":"J Rheumatol"},{"key":"bibr23-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90137-9"},{"issue":"12","key":"bibr24-0363546510364838","first-page":"933","volume":"33","author":"Lompa PA","year":"1998","journal-title":"Rev Bras Ortop"},{"key":"bibr25-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1177\/036354658901700504"},{"key":"bibr26-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505280427"},{"key":"bibr27-0363546510364838","volume-title":"A Colour Atlas of Human Anatomy","author":"McMinn RMH","year":"1993","edition":"3"},{"key":"bibr28-0363546510364838","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200737080-00004"},{"key":"bibr29-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.37.1.13"},{"key":"bibr30-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2005.12.003"},{"key":"bibr31-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507313572"},{"key":"bibr32-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1970.03170260032007"},{"key":"bibr33-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0838.2000.010005279.x"},{"key":"bibr34-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1177\/03635465000280041101"},{"key":"bibr35-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7410.323"},{"key":"bibr36-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B6.15833"},{"key":"bibr37-0363546510364838","first-page":"798","volume":"34","author":"Remvig L","year":"2007","journal-title":"J Rheumatol"},{"key":"bibr38-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-0080"},{"key":"bibr39-0363546510364838","first-page":"162","volume-title":"Evidence-Based Medicine: How to Practice and Teach EBM","author":"Sackett DL","year":"2000","edition":"2"},{"key":"bibr40-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2007.05.001"},{"key":"bibr41-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2004.015271"},{"key":"bibr42-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1007\/s001670100228"},{"key":"bibr43-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2003.004861"},{"key":"bibr44-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.01.006"},{"key":"bibr45-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1186\/1546-0096-7-1"},{"key":"bibr46-0363546510364838","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310061801"}],"container-title":["The American Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0363546510364838","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0363546510364838","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0363546510364838","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:41:54Z","timestamp":1777369314000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0363546510364838"}},"subtitle":["A Systematic Review With Meta-Analysis"],"short-title":[],"issued":{"date-parts":[[2010,7]]},"references-count":46,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2010,7]]}},"alternative-id":["10.1177\/0363546510364838"],"URL":"https:\/\/doi.org\/10.1177\/0363546510364838","relation":{},"ISSN":["0363-5465","1552-3365"],"issn-type":[{"value":"0363-5465","type":"print"},{"value":"1552-3365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,7]]}}}