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Atlantoaxial instability is a condition that can be present in some individuals with Down syndrome due to the anatomical differences in the cervical spine associated with the condition. This instability can lead to excessive movement at the atlantoaxial joint (between the first and second cervical vertebrae), which may increase the risk of spinal cord compression and serious injury, particularly during activities that involve contact or high-impact movements.

Sports participation can be dangerous for individuals with atlantoaxial instability, as activities that involve jumping, twisting, or collisions may exacerbate the condition. Therefore, medical professionals often recommend restrictions on participation in certain sports for individuals with Down syndrome who have this instability diagnosed through appropriate imaging or clinical assessment.

In contrast, while the other conditions may have implications for physical activity, they are not as commonly directly associated with restrictions for patients with Down syndrome. For example, slipped capital epiphysis and aortic aneurysm can certainly pose risks, but they are not specific to individuals with Down syndrome in the same way as atlantoaxial instability. Talar subluxation is also not a well-documented risk factor that would universally prevent participation in sports for this population.