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Review
.2014 Jan 22;2(1):2325967113518492.
doi: 10.1177/2325967113518492. eCollection 2014 Jan.

The Epidemiology of Injuries in Mixed Martial Arts: A Systematic Review and Meta-analysis

Affiliations
Review

The Epidemiology of Injuries in Mixed Martial Arts: A Systematic Review and Meta-analysis

Reidar P Lystad et al. Orthop J Sports Med..

Abstract

Background: Mixed martial arts (MMA) has experienced a surge in popularity since emerging in the 1990s, but the sport has also faced concomitant criticism from public, political, and medical holds. Notwithstanding the polarized discourse concerning the sport, no systematic review of the injury problems in MMA has been published to date.

Purpose: To systematically review the epidemiologic data on injuries in MMA and to quantitatively estimate injury incidence and risk factor effect sizes.

Study design: Systematic review and meta-analysis; Level of evidence, 4.

Methods: Electronic searching of PubMed, Scopus, CINAHL, EMBASE, AMED, and SPORTDiscus databases to identify studies reporting on the epidemiology of injuries in MMA. Random-effects models were used to obtain pooled summary estimates of the injury incidence rate per 1000 athlete-exposures (IIRAE) and rate ratios with 95% confidence intervals (CIs). Heterogeneity was evaluated with the I (2) statistic.

Results: A total of 6 studies were eligible for inclusion in this review. The IIRAE summary estimate was found to be 228.7 (95% CI, 110.4-473.5). No studies reported injury severity. The most commonly injured anatomic region was the head (range, 66.8%-78.0%) followed by the wrist/hand (range, 6.0%-12.0%), while the most frequent injury types were laceration (range, 36.7%-59.4%), fracture (range, 7.4%-43.3%), and concussion (range, 3.8%-20.4%). The most notable risk factors pertained to the outcome of bouts. Losers incurred 3 times as many injuries as winners, and fighters in bouts ending with knockout or technical knockout incurred more than 2 times as many injuries as fighters in bouts ending with submission.

Conclusion: Notwithstanding the paucity of data, the injury incidence in MMA appears to be greater than in most, if not all, other popular and commonly practiced combat sports. In general, the injury pattern in MMA is very similar to that in professional boxing but unlike that found in other combat sports such as judo and taekwondo. More epidemiologic research is urgently needed to improve the accuracy of the injury incidence estimate, to determine the injury severity, and to identify more risk factors for injury in MMA.

Keywords: athletic injury; incidence; mixed martial arts; risk factors.

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Conflict of interest statement

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram depicting the study selection process.
Figure 2.
Figure 2.
Forest plot of pooled estimate of the injury incidence rate (IIR) per 1000 athlete-exposures with 95% confidence intervals (CIs). NAC, Nevada Athletic Commission.aCalculated from Nevada Athletic Commission data (September 2001 to October 2009).
Figure 3.
Figure 3.
Forest plot of risk factor effect-size estimates (rate ratios [RRs] with 95% confidence intervals [CIs]). KO, knockout; NAC, Nevada Athletic Commission; TKO, technical knockout.aCalculated from Nevada Athletic Commission data (September 2001 to October 2009).
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