{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T09:55:08Z","timestamp":1791021308409,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>The recent international foot and ankle sports consensus and systematic review on navicular fractures in elite athletes addresses a highly relevant and challenging topic in sports medicine and provides valuable guidance in an area where standardized treatment and return to sport (RTS) recommendations remain limited. However, several methodological and reporting issues within the systematic review warrant clarification, given their potential influence on RTS decision\u2010making. The reported mean RTS time of 8.2 weeks after operative treatment of navicular stress fractures appears to result from an error in the extraction of time units. Recalculation based on the included studies, after converting all values to weeks, yields a mean RTS of approximately 19.7 weeks (4.5 months), consistent with the expert consensus recommendation of 4\u20136 months after surgery. Further discrepancies concern the application of the stated eligibility criteria: 5 of the 14 included studies were published outside the specified 15\u2010year window, and at least four involved cohorts with a mean age below 18 years despite paediatric studies being listed as an exclusion criterion. Further inconsistencies in study classification and reporting add to these concerns. We believe that clarification of these concerns is essential to ensure the reliability of the evidence base informing the consensus recommendations and to support accurate guidance for RTS decision\u2010making in elite athletes with navicular fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70632","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T09:04:46Z","timestamp":1791018286000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Navicular fractures in elite athletes: Clarifying the evidence base of the 2025 International Foot and Ankle Sports Consensus"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6587-0589","authenticated-orcid":false,"given":"Filip Jonah","family":"Zimmermann","sequence":"first","affiliation":[{"name":"Department of Osteology and Biomechanics University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Institute for Sports Osteology &amp; Performance Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2382-8348","authenticated-orcid":false,"given":"Michael","family":"Amling","sequence":"additional","affiliation":[{"name":"Department of Osteology and Biomechanics University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Institute for Sports Osteology &amp; Performance Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3325-8983","authenticated-orcid":false,"given":"Alexander","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Osteology and Biomechanics University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Institute for Sports Osteology &amp; Performance Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"issue":"8","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"885","DOI":"10.3390\/bioengineering10080885","article-title":"Outcomes using focused shockwave for treatment of bone stress injury in runners","volume":"10","author":"Beling A","year":"2023","journal-title":"Bioengineering"},{"issue":"12","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1177\/0363546505278253","article-title":"Tarsal navicular stress injury: long\u2010term outcome and clinicoradiological correlation using both computed tomography and magnetic resonance imaging","volume":"33","author":"Burne SG","year":"2005","journal-title":"Am J Sports Med"},{"issue":"2","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.55275\/JPOSNA-2022-0022","article-title":"Navicular stress fractures in adolescent athletes: injury characteristics and outcomes of surgical fixation","volume":"4","author":"Egger AC","year":"2022","journal-title":"J Pediatr Soc North Am"},{"issue":"5","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1136\/bjsm.2005.023465","article-title":"The incidence and distribution of stress fractures in elite tennis players","volume":"40","author":"Maquirriain J","year":"2006","journal-title":"Br J Sports Med"},{"issue":"8","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1177\/03635465231170399","article-title":"Tarsal navicular bone stress injuries: a multicenter case series investigating clinical presentation, diagnostic approach, treatment, and return to sport in adolescent athletes","volume":"51","author":"Mehta S","year":"2023","journal-title":"Am J Sports Med"},{"issue":"7","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta\u2010analyses: the PRISMA statement","volume":"6","author":"Moher D","year":"2009","journal-title":"PLoS Med"},{"issue":"1","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.3810\/psm.2005.01.34","article-title":"Navicular stress fractures in identical twin runners: high\u2010risk fractures require structured treatment","volume":"33","author":"Murray SR","year":"2005","journal-title":"Phys Sportsmed"},{"issue":"1","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1177\/10711007211034812","article-title":"Treatment of navicular stress fractures with an algorithmic approach","volume":"43","author":"Nunley JA","year":"2022","journal-title":"Foot Ankle Int"},{"issue":"8","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1136\/bjsm.2005.022079","article-title":"Navicular stress fractures: outcomes of surgical and conservative management","volume":"40","author":"Potter NJ","year":"2006","journal-title":"Br J Sports Med"},{"issue":"5","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1053\/j.jfas.2017.06.009","article-title":"Navicular stress fracture outcomes in athletes: analysis of 62 injuries","volume":"56","author":"Saxena A","year":"2017","journal-title":"J Foot Ankle Surg"},{"issue":"11","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1177\/107110070602701109","article-title":"Navicular stress fractures: a prospective study on athletes","volume":"27","author":"Saxena A","year":"2006","journal-title":"Foot Ankle Int"},{"issue":"9","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"3162","DOI":"10.1002\/ksa.70243","article-title":"Navicular fractures in elite athletes\u20102025 international foot and ankle sports consensus and systematic review","volume":"34","author":"Webber KJ","year":"2026","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"6","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1053\/j.jfas.2016.01.015","article-title":"Failure of internal fixation for painful bipartite navicular in two adolescent soccer players: a report of two cases","volume":"55","author":"Yamaguchi S","year":"2016","journal-title":"J Foot Ankle Surg"}],"container-title":["Knee Surgery, Sports Traumatology, 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