510 BO35 – Incidence of knee injuries in Swedish olympic athletes: an analysis of insurance registry data over 22 years

Background The knee is among the most injured locations in Olympic athletes. However, there remains a paucity of research regarding the potential differences in knee injury incidence between various groups of Olympic athletes. Objective To study the knee injury incidence in Swedish Olympic athletes and compare between subgroups of athletes. Design Insurance registry-based cohort study. Setting Olympic athletes. Patients (or Participants) Male and female athletes within the Swedish Olympic Committee support programme 'Top and Talent' were included. Data from January 1999 to December 2020 was analysed, with a total of 762 athletes (3427 athlete-years) in 38 sports. Interventions (or Assessment of Risk Factors) Knee injury incidence was compared between subgroups of athletes based on sport, sport category, competitive season, sex, and age groups. Main outcome measurements Sudden and gradual onset knee injury was reported to the insurance company by the athletes' medical team. Incidence rate was calculated as the number of knee injuries divided by the sum of athlete-years multiplied by 100, and expressed as injuries per 100 athlete-years. Results The incidence of knee injuries was highest in wrestling, freestyle skiing and gymnastics (30.3, 27.8, and 27.6 injuries/100 athlete-years, respectively). Power sports had higher incidence compared to skill sports (rate ratio, RR 4.3, 95% CI 3.1–5.8), endurance sports (RR 3.8, 95% CI 2.9–5.2) and mixed sports (RR 1.9, 95% CI 1.4–2.4). Winter sports had higher incidence than summer sports (RR 1.3, 95% CI 1.1–1.6). There was no difference in overall incidence between males and females (RR 1.0, 95% CI 0.8–1.2), but females had higher incidence of ligament and meniscal injuries (RR 2.0, 95% CI 1.3–3.2). Incidence was highest in the youngest age groups ≤ 20 years and 21–25 years. Conclusions The knee injury incidence varies across different groups of Olympic athletes, emphasizing the need for targeted knee injury preventive measures.