Does sports participation (including level of performance and previous injury) increase risk of osteoarthritis? A systematic review and meta-analysis

Abstract

BackgroundTo assess the relationship between sport and osteoarthritis (OA), and specifically to determine whether previous participation, in terms of level (elite or non-elite), type of sport, intensity or previous injury, was associated with OA.MethodsThis systematic review was developed using PRISMA guidelines. Databases were searched (to May 2016). Narrative review and meta-analysis (with risk ratio (RR) and 95% CIs) approaches were undertaken where appropriate. Study quality was assessed using GRADE.Results46 studies were included. Narratively, 31 studies reported an increased risk of OA, with 19 demonstrating an increased risk in elite athletes. There was an increased risk after sports exposure (irrespective of type; RR 1.37; 95% CI 1.14 to 1.64; 21 studies). It remained uncertain whether there was a difference in risk of OA between elite and non-elite athletes (RR 1.37; 95% CI 0.84 to 2.22; 17 studies). The risk was higher in soccer (RR 1.42; 95% CI 1.14 to 1.77; 15 studies) but lower in runners (RR 0.86; 95% CI 0.53 to 1.41; 12 studies). 9 studies showed an association with the intensity of sport undertaken and OA. 5 studies demonstrated a higher prevalence of OA following meniscectomies and anterior cruciate ligament tears. Overall, the evidence was of GRADE ‘very low’ quality.ConclusionsThere was very low-quality evidence to support an increased relationship between sports participation and OA in elite participants. It is unclear whether there is a difference in risk between elite and non-elite participants with further prospective studies needed to evaluate this. Pooled findings suggested that significant injuries were associated with OA in soccer players.

Prevalence of knee pain, radiographic osteoarthritis and arthroplasty in retired professional footballers compared with men in the general population: a cross-sectional study

“…The prevalence of CC was significantly higher in ex-footballers (24.3%) compared with the general population (8.8%) and previous population estimates (7%–10%). 29 Both KOA and prior joint insult are recognised risk factors for CC, 11 so this increased prevalence is consistent with more biomechanical knee trauma in footballers. Furthermore, concurrence of CC with KOA may associate with greater clinical severity and worse outcomes.…”

“… 2 Indeed, a recent systematic review cited the same limitations and concluded that only ‘very low quality’ evidence suggests football increases the risk of KOA. 11 No studies have used a general population group for comparison, so whether ex-footballers have more KOA than the general population remains unknown.…”

Sport – zu Risiken und Nebenwirkungen

“…Im Bereich der unteren Extremität besteht ein erhöhtes Risiko für Arthrosen im Knie-und Hüftgelenk in Kraftsportarten sowie in Sportarten mit schnellen Richtungswechseln [36]. Beispielsweise zeigt sich im Fußball, nicht jedoch im Laufsport, ein erhöhtes Risiko für Arthrose bei Elitesportlern im Vergleich zu Nichtelitesportlern [42]. Höheres Körpergewicht scheint mit einem erhöhten Risiko für Arthrosen im Knie-und Hüftgelenk assoziiert zu sein [36].…”

Knee Osteoarthritis and Running: Is there any Evidence for Association?

“…In a systematic review and meta-analysis, Tran and associates concluded that there is very low quality evidence to support the increased relationship between sports participation and OA in elite participants [19]. Similarly, findings from the osteoarthritis initiative shows there is no increase in symptomatic knee OA among selfselected runners when compared to non-runners and running is not detrimental in people without OA knee [20].…”