Investigation of lower extremity injuries in men's ice hockey: a 10-year analysis across the COVID-19 era.

Abstract

Over one-third of icehockey injuries involve the lower extremity (LE). The purpose of this study was to describe epidemiology and mechanism of injury of men's icehockey-related lower extremity injuries treated in US emergency departments from 2013 to 2022. The National Electronic Injury Surveillance System (NEISS) database was retrospectively queried for LE injuries related to men's ice hockey (product code 1279) from 2013 to 2022. Demographics, injury characteristics, and disposition were recorded. Injury mechanism was summarized from the supplied narrative. National estimates (NE) were calculated using the provided NEISS sample weight. Linear regression was used to evaluate injurytrends. There were 832 cases (NE: 27469) of LE injuries in male ice hockey players from 2013-2022. Linear regression demonstrated increasing LE injuries in the post-COVID period (after the year 2020). The knee (34.7%, NE: 9,533) and ankle (29.4%, NE: 8,089) were most commonly injured. The most frequent injuries for the ankle (35.8%) and knee (30.5%) were strains/sprains. Skating sprains (15.1%, NE: 4,157) and slip and/or falls (14.2%, NE: 3,898) were the most common primary mechanisms of injury. Slip and/or falls (40.8%) and collisions with another player (23.9%) were most common secondarymechanisms of injury.  Slip and/or falls, collisions with another player,and checking commonly injured the knee. There were no significant changes in ininjury incidence at any anatomical location or primary mechanism of injury overthe study period. The knee and ankle were the most common location of lower extremityinjuries in male ice hockey players between 2013-2022. The knee was vulnerable to a variety of primary mechanisms ofinjury, including checking, collisions with other players, and slip and/or falls. Despite implementation of urgent orthopedic carecenters, allowance of additional foot protection, and facility improvements, the rate of post-COVID LE injuries have been increasing.