Former Male Elite Athletes Have a Higher Prevalence of Osteoarthritis and Arthroplasty in the Hip and Knee Than Expected

Abstract

Background: Intense exercise has been reported as one risk factor for hip and knee osteoarthritis (OA).

Purpose: This study aimed to evaluate (1) whether this is true for both former impact and nonimpact athletes, (2) if the risk of a hip or knee arthroplasty due to OA is higher than expected, and (3) if joint deterioration is associated with knee injuries.

Study Design: Cohort study; Level of evidence, 3.

Methods: The prevalence of OA and arthroplasty in the hip and knee were registered in 709 former male elite athletes with a median age of 70 years (range, 50-93 years), retired from sports for a median 35 years (range, 1-63 years), and compared with 1368 matched controls. Odds ratios (ORs) are presented as means with 95% confidence intervals (95% CIs).

Results: The risk of hip or knee OA was higher in former athletes (OR, 1.9; 95% CI, 1.5-2.3), as was arthroplasty based on OA in either of these joints (OR, 2.2; 95% CI, 1.6-3.1). The risk of hip OA was doubled (OR, 2.0; 95% CI, 1.5-2.8) and hip arthroplasty was 2.5 times higher (OR, 2.5; 95% CI, 1.6-3.7) in former athletes than in controls, predominantly driven by a higher risk in former impact athletes. Also, the risk of knee OA was higher (OR, 1.6; 95% CI, 1.3-2.1), as was knee arthroplasty (OR, 1.6; 95% CI, 0.9-2.7), driven by a higher risk in both former impact and nonimpact athletes. Knee OA in impact athletes was associated with knee injury.

Conclusion: Hip and knee OA and hip and knee arthroplasty are more commonly found in former male elite athletes than expected. A previous knee injury is associated with knee OA in former impact athletes but not in nonimpact athletes.

Keywords

arthroplasty football former athletes hip injury joint replacement osteoarthritis (OA)runners soccer soft tissue knee injury sport

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References

Arden

Nevitt

. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol. 2006;20(1):3-25.

Buckwalter

Lane

. Athletics and osteoarthritis. Am J Sports Med. 1997;25(6):873-881.

Conaghan

. Update on osteoarthritis, part 1: current concepts and the relation to exercise. Br J Sports Med. 2002;36(5):330-333.

Drawer

Fuller

. Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br J Sports Med. 2001;35(6):402-408.

Dye

. The knee as a biologic transmission with an envelope of function: a theory. Clin Orthop Relat Res. 1996;325:10-18.

Fairbank

. Knee joint changes after meniscectomy. J Bone Joint Surg Br. 1948;30(4):664-670.

Hurley

. The role of muscle weakness in the pathogenesis of osteoarthritis. Rheum Dis Clin North Am. 1999;25(2):283-298, vi.

Karlsson

Linden

Karlsson

Johnell

Obrant

Seeman

. Exercise during growth and bone mineral density and fractures in old age. Lancet. 2000;355(9202):469-470.

Kettunen

Kujala

Kaprio

Koskenvuo

Sarna

. Lower-limb function among former elite male athletes. Am J Sports Med. 2001;29(1):2-8.

10.

Konradsen

Hansen

Sondergaard

. Long distance running and osteoarthrosis. Am J Sports Med. 1990;18(4):379-381.

11.

Kujala

Kaprio

Sarna

. Osteoarthritis of weight bearing joints of lower limbs in former elite male athletes. BMJ. 1994;308(6923):231-234.

12.

Lane

Oehlert

Bloch

Fries

. The relationship of running to osteoarthritis of the knee and hip and bone mineral density of the lumbar spine: a 9 year longitudinal study. J Rheumatol. 1998;25(2):334-341.

13.

Lindberg

Roos

Gardsell

. Prevalence of coxarthrosis in former soccer players: 286 players compared with matched controls. Acta Orthop Scand. 1993;64(2):165-167.

14.

Lohmander

Englund

Dahl

Roos

. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. 2007;35(10):1756-1769.

15.

Manning

Hudson

. Comparison of hip joint range of motion in professional youth and senior team footballers with age-matched controls: an indication of early degenerative change? Phys Ther Sport. 2009;10(1):25-29.

16.

Marti

Knobloch

Tschopp

Jucker

Howald

. Is excessive running predictive of degenerative hip disease? Controlled study of former elite athletes. BMJ. 1989;299(6691):91-93.

17.

Michaëlsson

Byberg

Ahlbom

Melhus

Farahmand

. Risk of severe knee and hip osteoarthritis in relation to level of physical exercise: a prospective cohort study of long-distance skiers in Sweden. PLoS One. 2011;6(3):e18339.

18.

Nebelung

Wuschech

. Thirty-five years of follow-up of anterior cruciate ligament-deficient knees in high-level athletes. Arthroscopy. 2005;21(6):696-702.

19.

Neyret

Donell

DeJour

. Partial meniscectomy and anterior cruciate ligament rupture in soccer players: a study with a minimum 20-year followup. Am J Sports Med. 1993;21(3):455-460.

20.

Nilsson

Westlin

. Bone density in athletes. Clin Orthop. 1971;77:179-182.

21.

Nordstrom

Karlsson

Nyquist

Olsson

Nordstrom

Karlsson

. Bone loss and fracture risk after reduced physical activity. J Bone Miner Res. 2005;20(2):202-207.

22.

Panush

Schmidt

Caldwell

. Is running associated with degenerative joint disease? JAMA. 1986;255(9):1152-1154.

23.

Powell

Paffenbarger

Jr.

Workshop on Epidemiologic and Public Health Aspects of Physical Activity and Exercise: a summary. Public Health Rep. 1985;100(2):118-126.

24.

Radin

Burr

Caterson

Fyhrie

Brown

Boyd

. Mechanical determinants of osteoarthrosis. Semin Arthritis Rheum. 1991;21(3 Suppl 2):12-21.

25.

Roos

. [Increased risk of knee and hip arthrosis among elite athletes: lower level exercise and sports seem to be "harmless"]. Lakartidningen. 1998;95(42):4606-4610.

26.

Shepard

Banks

Ryan

. Ex-professional association footballers have an increased prevalence of osteoarthritis of the hip compared with age matched controls despite not having sustained notable hip injuries. Br J Sports Med. 2003;37(1):80-81.

27.

Shrier

. Muscle dysfunction versus wear and tear as a cause of exercise related osteoarthritis: an epidemiological update. Br J Sports Med. 2004;38(5):526-535.

28.

Slemenda

Brandt

Heilman

. Quadriceps weakness and osteoarthritis of the knee. Ann Intern Med. 1997;127(2):97-104.

29.

Sohn

Micheli

. The effect of running on the pathogenesis of osteoarthritis of the hips and knees. Clin Orthop Relat Res. 1985;198:106-109.

30.

Sutton

Muir

Mockett

Fentem

. A case-control study to investigate the relation between low and moderate levels of physical activity and osteoarthritis of the knee using data collected as part of the Allied Dunbar National Fitness Survey. Ann Rheum Dis. 2001;60(8):756-764.

31.

Vignon

Valat

Rossignol

. Osteoarthritis of the knee and hip and activity: a systematic international review and synthesis (OASIS). Joint Bone Spine. 2006;73(4):442-455.

32.

Vingard

Alfredsson

Goldie

Hogstedt

. Occupation and osteoarthrosis of the hip and knee: a register-based cohort study. Int J Epidemiol. 1991;20(4):1025-1031.

33.

Vingard

Alfredsson

Goldie

Hogstedt

. Sports and osteoarthrosis of the hip: an epidemiologic study. Am J Sports Med. 1993;21(2):195-200.

34.

Vingard

Alfredsson

Malchau

. Osteoarthrosis of the hip in women and its relationship to physical load from sports activities. Am J Sports Med. 1998;26(1):78-82.

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