Citation

Oudmaijer M, Koolen O, van der Meij L, Kloprogge S, Gerger H. Am. J. Sports Med. 2024; 52(1): NP1-NP2.

Copyright

(Copyright © 2024, American Orthopaedic Society for Sports Medicine, Publisher SAGE Publishing)

DOI

10.1177/03635465231209991

PMID

38164677

Abstract

We are writing to express our concerns regarding the recently published article titled, "Lower Extremity Injury Rates on Artificial Turf Versus Natural Grass Playing Surfaces: A Systematic Review."2 We highly appreciate the diligent effort invested into conducting a systematic review on this important topic. However, we kindly suggest that certain aspects be taken into consideration that might limit the clarity, reliability, and validity of the article's conclusions.

First, and most important, the article lacks information on effect sizes, their statistical significance, and the sample size of the included studies. Reporting this information for each included study would be valuable for prioritizing certain results for summary and synthesis.1 Therefore, including effect sizes, statistical significance and sample size of the studies would contribute considerably to enhance interpretability of the summarized findings, limit risk of bias, and enhance transparency.

Our second point of concern is the risk of bias assessment for the included studies. A more recent systematic review and meta-analysis on injuries sustained on artificial turf compared with grass found that the risk of bias was a pervasive issue.3 We deeply value the reporting of the level of evidence and assessment of the cohort selection processes. However, it would have been beneficial if the authors had reported the cohort selection process for each study and preferably used a more comprehensive quality assessment of the included studies, such as the ROBINS-I (Risk of Bias in Nonrandomized Studies-of Interventions) tool.5 A thorough evaluation of the risk of bias would have provided valuable insights into the quality and potential sources of bias in the literature.

Moreover, when results are summarized...

Language: en

Keywords

Humans; *Athletic Injuries/epidemiology/etiology; *Knee Injuries; *Leg Injuries/epidemiology/etiology; Lower Extremity/injuries; Poaceae