ObjectivesTo determine the prevalence of knee pain, radiographic knee osteoarthritis (RKOA), total knee replacement (TKR) and associated risk factors in male ex-professional footballers compared with men in the general population (comparison group).Methods1207 male ex-footballers and 4085 men in the general population in the UK were assessed by postal questionnaire. Current knee pain was defined as pain in or around the knees on most days of the previous month. Presence and severity of RKOA were assessed on standardised radiographs using the Nottingham Line Drawing Atlas (NLDA) in a subsample of 470 ex-footballers and 491 men in the comparison group. The adjusted risk ratio (aRR) and adjusted risk difference (aRD) with 95% CI in ex-footballers compared with the general population were calculated using the marginal model in Stata.ResultsEx-footballers were more likely than the comparison group to have current knee pain (aRR 1.91, 95% CI 1.77 to 2.06), RKOA (aRR 2.21, 95% CI 1.92 to 2.54) and TKR (aRR 3.61, 95% CI 2.90 to 4.50). Ex-footballers were also more likely to present with chondrocalcinosis (aRR 3.41, 95% CI 2.44 to 4.77). Prevalence of knee pain and RKOA were higher in ex-footballers at all ages. However, even after adjustment for significant knee injury and other risk factors, there was more than a doubling of risk of these outcomes in footballers.ConclusionsThe prevalence of all knee osteoarthritis outcomes (knee pain, RKOA and TKR) were two to three times higher in male ex-footballers compared with men in the general population group. Knee injury is the main attributable risk factor. Even after adjustment for recognised risk factors, knee osteoarthritis appear to be an occupational hazard of professional football.

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ObjectivesTo determine the prevalence of depressive symptoms and general health of male ex-professional footballers compared with general population controls.Methods572 retired professional footballers and 500 general population controls in the UK were assessed by postal questionnaire. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale and a threshold score of ≥11 was used to indicate probable caseness. General health was ascertained using the Short Form-12 Health Survey Questionnaire quality of life (QoL) tool; self-reported comorbidities, analgesic usage and body pain; and Index of Multiple Deprivation based on postcode data. Mood was assessed using the Positive and Negative Affect Scale and sleep using the Medical Outcome Survey. Linear regression analysis was used to determine adjusted relative risk with 95% CI and adjusted for age, body mass index, comorbidities, body pain and medication usage.ResultsThe prevalence of depressive symptoms in retired professional footballers was 5.66% compared with 5.76% in the general population and anxiety prevalence was also comparable (12.01% vs 10.29%; all p>0.05). However, footballers had lower physical and mental component scores compared with controls (p<0.01). They also reported significantly more sleep problems, more negative mood profiles and more widespread body pain (adjusted relative risk (aRR) 1.88, 95% CI 1.15 to 3.09). They also reported greater pain medication usage compared with controls (aRR 1.54, 95% CI 1.26 to 1.89). However, compared with controls, they were 26% (95% CI 15% to 37%) less likely to report comorbidities, especially heart attacks (aRR 57%, 95% CI 27% to 74%) and diabetes (aRR 61%, 95% CI 37% to 76%).ConclusionsThe prevalence of depressive symptoms and anxiety symptoms and probable caseness in ex-professional footballers is comparable with general population controls. However, ex-footballers reported lower health-related QoL, more widespread body pain and higher analgesic usage. Conversely, lower reporting of diabetes and heart attacks indicates potential long-term physical health benefits of professional football.

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(2015) Motive8!: feasibility of a text messaging intervention to promote physical activity in knee osteoarthritis. International Journal of Sports and Exercise Medicine, 1 (5). pp. 1-8. ISSN 2469-5718 Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/38426/1/Blake%20et%20al%20Motive8%20IJSEM-1-027-3.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the Creative Commons Attribution licence and may be reused according to the conditions of the licence. For more details see: http://creativecommons.org/licenses/by/2.5/ A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. Methods: 27 people (6 male, 21 female; aged 25-81 years) with knee osteoarthritis received 4 text messages per week, for 6 weeks. Telephone surveys were conducted at baseline and 6 weeks to pain. Participants completed physical activity diaries. Process evaluation included participant perceptions of the intervention of delivery and response data) and participant engagement (text response).Results: 648 messages were sent, 100% were accurately exercise and pain. Participants engaged with the intervention; 100% read the messages, 89% responded to texts requesting replies, 64% completed physical activity diaries with low attenuation (1.8% drop) by six weeks. Participants perceived messaging to be enjoyable (96%), personally relevant (85%), of appropriate frequency (100%) and duration (88%). Mobile phones, email and web were perceived to be most acceptable for health promotion compared with other forms of technology. Conclusions:People with knee osteoarthritis can engage meaningfully with an interactive mobile phone messaging intervention over a six-week period. Health communications promoting physical activity demonstrate potential for behaviour change and positive implications for perceptions of exercise and pain; this needs to be tested in a randomised trial. Data collected in 'real-time' can be used for process evaluation to demonstrate

SummaryObjectivesTo examine the prevalence of synovial effusion, synovial hypertrophy and positive Doppler signal (DS) detected by ultrasound (US) in people with knee osteoarthritis (OA) and/or knee pain compared to that in the general population.MethodA systematic literature search was undertaken in Medline, EMBASE, Allied and Complementary Medicine, PubMed Web of Science, and SCOPUS databases in May 2015. Frequencies of US abnormalities in people with knee OA/pain, in the general population or asymptomatic controls were pooled using the random effects model. Publication bias and heterogeneity between studies were examined.ResultsTwenty four studies in people with knee pain/OA and five studies of the general population or asymptomatic controls met the inclusion criteria. The pooled prevalence of US effusion, synovial hypertrophy and positive DS in people with knee OA/pain were 51.5% (95% CI 40.2 to 62.8), 41.5% (26.3–57.5) and 32.7% (8.34–63.24), respectively, which were higher than those in the general population or asymptomatic controls (19.9% (95%CI 7.8–35.3%), 14.5% (0–58.81), and 15.8 (3.08–35.36), respectively). People with knee OA (ACR criteria or radiographic OA) had greater prevalence of US abnormalities than people with knee pain (P = 0.037, P = 0.010 and P = 0.009, respectively).ConclusionsUS detected effusion, synovial hypertrophy and DS are more common in people with knee OA/pain, compared to the general population. These abnormalities relate more to presence of OA structural changes than to pain.

Glass fiber reinforced polymer (GFRP) bridge deck systems offer an attractive alternative to concrete decks, particularly for bridge rehabilitation projects. Current design practice treats GFRP deck systems in a manner similar to concrete decks. The results of this study, however, indicate that this may result in non-conservative design values for the bridge girders. Results from a number of in situ load tests of three steel girder bridges having the same (GFRP) deck system are used to determine the degree of composite action that may be developed and the transverse distribution of wheel loads that may be assumed for such structures. Results indicate that appropriately conservative design values may be found by assuming no composite action between GFRP deck and steel girder and using the lever rule to determine transverse load distribution. When used to replace an existing concrete deck, the lighter GFRP deck will result in lower total loads applied to the bridge structure, although, due to the decreased effective width and increased distribution factors, local flange stresses and particularly the live load-induced stress range is likely to be increased. Thus, existing fatigue-prone details may become a concern and require attention in design.iii