Patterns and Trends of Foot and Ankle Injuries in Olympic Athletes: A Systematic Review and Meta-analysis

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ORIGINAL ARTICLE

Patterns and Trends of Foot and Ankle Injuries in Olympic Athletes: A Systematic Review and Meta‑analysis Siddhartha Sharma1 · Mandeep S. Dhillon1 · Prasoon Kumar1 · Rajesh Kumar Rajnish1 Received: 28 January 2020 / Accepted: 19 February 2020 © Indian Orthopaedics Association 2020

Abstract Introduction  Foot and ankle injuries in elite athletes can result in decreased performance, absence from sport and prolonged morbidity. There is paucity of data on foot and ankle injuries in Olympics athletes. Methods  We conducted a systematic review of the PubMed and EMBASE databases. Studies in English language that reported the incidence and/or prevalence of foot and ankle injuries in during Olympics games (summer, winter and youth Olympics) were included. Studies in languages other than English, those that looked at injuries other than foot and ankle injuries, studies looking at injuries in non-Olympics events and those looking at Olympics trials were excluded. We determined the injury rates and burden of foot and ankle injuries. We also looked at the patterns and trends of foot and ankle injuries. Results  A total of 399 foot and ankle injuries from 25 publications were included in the review. Foot and ankle injury rates ranged from 0.09 to 0.42 injuries per athlete-years for summer Olympics and 0.02–0.35 injuries per athlete-years for winter Olympics. Quantitative analysis revealed that foot and ankle injuries contributed to 16.9% of all injuries (95% CI 8.1–31.9%) for summer Olympics and 5.1% of all injuries (95% CI 1.9–12.6%) for winter Olympics; however, a high statistical heterogeneity was noted. The three most common injuries were tendon injuries, ligament injuries and stress fractures. The rates and burden of foot and ankle injuries showed a declining trend. Conclusions  Foot and ankle injuries are an important cause of morbidity amongst Olympics athletes. The declining trend amongst these injuries notwithstanding, there is a need for a global electronic database for reporting of injuries in Olympics athletes. Keywords  Olympics · Foot and ankle · Injuries · Meta-analysis · Sport · Injury prevention

Introduction The modern Olympics games are considered as the pinnacle of all sporting events and participation has steadily increased ever since their inception in 1896. As is the case with any mass sporting event, sport-related injuries are a major concern, both for the athletes as well as the organizers [1–3]. It has been shown that foot and ankle injuries can affect athletic performance adversely, result in absence from sport and can also have long-term impact on the athletes’ wellbeing [4–6]. However, data on foot and ankle injuries in Olympics athletes is scarce. Hence, this study was done to

* Siddhartha Sharma [email protected] 1



determine the patterns and trends of foot and ankle injuries in Olympic athletes.

Methods This was a systematic review and meta-analysis, and was done in accordance with PRISMA guidelines [7].

Search Strategy The primary search was conducted on the PubMed and EMB