Abstract
BACKGROUND: Anterior Cruciate Ligament (ACL) injuries pose a significant risk in sports, often leading to long rehabilitation and re-injury. The Landing Error Scoring System (LESS) has been proposed as a means of assessing the risk of potential ACL damage. This study employed Network meta-analysis to assess the effectiveness of various preventive interventions in reducing ACL injury risk among athletes, utilizing LESS evaluation tool to identify the most effective strategies. METHODS: A comprehensive search for related publications in English in databases, such as WOS, Cochrane Library, Embase, PubMed, and Scopus from the establishment of the databases to February 2025. Relevant content in the literature that passed the screening criteria was extracted, including the sample, first author, intervention, intervention duration, and outcome. We compared the Mean Difference (MD) values across studies and used network meta-analysis based on Bayesian modelling. RESULTS: A Network meta-analysis of 20 studies (N = 1,356) was conducted. After comparison, assessing the impact of eight training interventions on the LESS scores. Dynamic Taping (MD, -1.87, 95% CrI, -3.29 to -0.46), Neuromuscular Training (MD, -1.04, 95% CrI, -2.01 to -0.10), and Feedback Training (MD, -0.86 95% CrI, -1.54 to -0.20) were the most effective in reducing injury risk. The SUCRA rankings from highest to lowest are as follows: Dynamic Taping (79.0), Neuromuscular Training (53.2), and Feedback Training (43.0). CONCLUSION: Network meta-analysis simultaneously integrates evidence from both direct comparisons and indirect comparisons. Evidence from Network meta-analysis based on Bayesian models, Dynamic Taping, Neuromuscular Training and Feedback Training are effective intervention training programs for ACL injury prevention. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-025-09290-8.