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Overall, an individual with a lateral ankle sprain had a greater risk of a subsequent lateral ankle sprain than an uninjured person.
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After a lateral ankle sprain, the risk of a subsequent lateral ankle sprain was increased for men but not for women.
Lateral ankle sprain (LAS) is the most common lower extremity musculoskeletal injury1,2 and affects individuals of all ages participating in organized sports or unstructured play.3 The LAS is often erroneously considered a 1-time injury, but researchers4 have estimated that up to 74% of individuals who sustain an LAS will develop persistent adverse outcomes (eg, pain, swelling, weakness, and instability), often referred to as chronic ankle instability. An LAS has also been linked with ankle-joint degeneration and posttraumatic osteoarthritis.5 In addition to the long-term health-related consequences, LASs and their sequelae represent a significant financial burden on injured individuals and the health care system.3
Due to the extensive cost and burden of LASs, numerous authors have focused on identifying both the intrinsic (eg, balance) and extrinsic (eg, LAS history) risk factors for initial and recurrent LASs.2,6–9 Whereas multiple factors likely contribute to the risk of recurrent LAS, an LAS history has been accepted as a major risk factor for 2 main reasons: (1) selective referencing in the existing literature (ie, only citing work supporting the case being made) and (2) an LAS causes many of the other investigated risk factors (eg, poor balance, ligamentous laxity).10–12 This belief may be erroneous given that (1) a body of evidence13–17 indicates that an LAS history does not increase the risk of a subsequent LAS, and (2) no systematic examination of the cumulative literature has been completed. Due to the conflicting results across the literature, a systematic examination is necessary to gain a comprehensive understanding of how an LAS history may influence the subsequent LAS risk and thus appropriately inform primary and secondary prevention strategies (ie, prevention of index injuries and subsequent rehabilitation protocols).
Epidemiologic studies6,7,18–20 have suggested that women may be at higher risk of sustaining an initial LAS. However, fewer data exist regarding the risk of subsequent LASs among women. Only 1 study7 of collegiate athletes showed that recurrent LASs did not...