Lateral ankle sprain increases subsequent ankle sprain risk: a systematic review

Abstract

Abstract Objective: To evaluate the evidence surrounding the association between lateral ankle sprain (LAS) history and subsequent LAS risk, as well as sex-differences in the observed associations. Data Sources: PubMed, CINAHL, and SPORTDiscus were searched through July 2020 for articles reporting LAS injury history and injury incidence during a study period. Study Selection: Studies were included if they were prospective in nature, reported the number of participants with and without a history of LAS at study initiation, and reported the number of participants from each group that sustained a LAS during the study period. Data Extraction: Data included study design parameters as well as the number of participants with and without a LAS history, and the number of subsequent LAS that occurred to both groups. Risk ratios (RR) with 95% confidence intervals (CI) compared the risk of LAS within the study period between those with and without a LAS history for each included investigation. Data Synthesis: Nineteen studies with a total of 6,567 patients were included. Follow-up periods ranged from 14 weeks to 2 years. Quality assessment scores indicate moderate to high quality studies were included. A significantly higher risk of LAS within the study period was observed among those with a history of LAS in 10 out of 15 studies (RR range=1.29–6.06). Similar associations were seen in four out of six studies that included an all-male sample (RR Range=1.38–8.65), and one out of four studies with an all-female sample (RR=4.28). Conclusion: There is strong evidence to support that a previous LAS increases the risk of a subsequent LAS injury. Males but not females with a history of a LAS appear to be at a higher risk of sustaining a subsequent LAS but further data are needed to draw definitive conclusions based on the limited number of sex specific studies.