Original Research
A Large-Scale Study on Epidemiology and Risk Factors for Chronic Ankle Instability in Young Adults

https://doi.org/10.1053/j.jfas.2014.06.001Get rights and content

Abstract

Up to 40% of ankle sprains can result in chronic ankle instability (CAI). The prevalence of CAI and its association with body mass index (BMI) and height in the general young adult population has not been reported. The database records of young adults before recruitment into mandatory military service were studied. Information on the disability codes associated with CAI was retrieved. Logistic regression models were used to assess the association between the BMI and body height with various grades of CAI severity. The study cohort included 829,791 subjects (470,125 males and 359,666 females). The prevalence was 0.7% for mild CAI and 0.4% for severe instability in males and 0.3% and 0.4%, respectively, for females (p < .001). An increased BMI was associated with ankle instability in males (overweight, odds ratio [OR] 1.249, p < .001; obese, OR 1.418, p < .001) and females (overweight, OR 1.989 p < .001; obese, OR 2.754, p < .001). The body height was associated with an increased risk of CAI when the highest height quintile was compared with the lowest height quintile in both males (OR 2.443, p < .001) and females (OR 1.436, p < .001) for all levels of instability severity. The present study has shown a greater prevalence of CAI among males than females in a general healthy young adult population. CAI was associated with an increased BMI and greater body height for all grades of instability severity.

Section snippets

Patients and Methods

The Israeli Defense Forces review board approved the present cross-sectional epidemiologic study. As previously reported, we used the medical database to investigate the association between the anthropomorphic data and clinical disability codes 15, 16.

The database contains the records of every 17-year-old Israeli citizen, who are obligated by law to report to specialized recruiting centers for comprehensive medical evaluation. The individuals of certain minority populations have been exempted,

CAI Prevalence

The study population included 829,791 adolescents (470,125 males and 359,666 females). The characteristics of the study population are listed in Table 2. The mean BMI and mean height was 22.04 ± 3.8 kg/m2 and 174.1 ± 6.8 cm for the males and 21.8 ± 3.7 kg/m2 and 162.1 ± 6.25 cm, respectively for the females. A total of 5441 males (1.1%) and 2531 females (0.7%) had a CAI code. The prevalence was 0.7% and 0.4% for mild and severe CAI among the males and 0.3% and 0.4% among the females,

Discussion

Determining the true prevalence of CAI in the general population and evaluating the risk factors associated with CAI requires a large cohort to provide the statistical power suitable to demonstrate subtle associations. Our access to an extensive medical database containing the relevant information on a heterogeneous and healthy population of 17-year-old subjects enabled us to estimate the prevalence of CAI and the various grades of CAI severity. We also could explore the association of CAI with

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    Financial Disclosure: None reported.

    Conflict of Interest: None reported.

    Drs. Hershkovich and Tenenbaum contributed equally to the report and should be considered co-first authors.

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