Higher Fat Mass Is Associated With a History of Knee Injury in Youth Sport

Abstract

Study Design Historical cohort study. Background History of a knee joint injury and increased fat mass are risk factors for joint disease. Objective The objective of this study was to examine differences in adiposity, physical activity, and cardiorespiratory fitness between youths with a 3- to 10-year history of sport-related intra-articular knee injury and uninjured controls. Methods One hundred young adults (aged 15-26 years; 55% female) with a sport-related intra-articular knee injury sustained 3 to 10 years previously and 100 controls matched for age, sex, and sport, who had no history of intra-articular knee injury, were recruited. Fat mass index (FMI) and abdominal fat (fat mass at the L1 to L4 vertebral levels) were derived using dual-energy X-ray absorptiometry. Physical activity and cardiorespiratory fitness were measured using the Godin Leisure-Time Exercise Questionnaire and the multistage 20-meter shuttle run test for aerobic fitness, respectively. Results Previously injured participants demonstrated higher FMI (within-pair difference, 1.05 kg/m; 95% confidence interval [CI]: 0.53, 1.57) and abdominal fat (461 g; 95% CI: 228, 694) than uninjured controls. In multivariable linear regression analysis, previous injury was significantly associated with increased FMI. This increase was attenuated in those who participated in higher levels of physical activity or had higher estimated maximum volume of oxygen. Conclusion As a risk factor for osteoarthritis in an already susceptible group, excess adiposity is an undesirable trait in the potential pathway to joint disease. Increasing physical activity in this population may be a potential intervention to reduce adiposity thus impede disease initiation and/or progression. Level of Evidence Level 2b. J Orthop Sports Phys Ther 2017;47(2):80-87. doi:10.2519/jospt.2017.7101.

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“…The lower-limb focussed group had a 27% increase in people participating in Level 3 activities who were previously sedentary, as many participants commenced strengthtraining and running. Ongoing strength-training and running participation may be important for future kneejoint and overall health (16,18), given a less active lifestyle and weight gain (i.e., increased BMI) is common after ACL injury (64), which may increase the risk of early OA progression (51,70). Combined, the improvements in satisfaction, self-reported function and physical activity may reduce future healthcare use (e.g.…”

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“…One hundred participants who had sustained a sport-related intraarticular knee injury 3e10 years previously and 100 age (within ±12 months), sex and sport (at time of injury) uninjured matched controls; all active youth in Calgary. Recruitment sources (Sport Injury Prevention Research Centre, and Sport Medicine Centre, both at the University of Calgary), injury diagnoses procedures and inclusion/exclusion criteria have previously been reported 21,22 . In summary, injured participants had sustained an intra-articular knee injury (i.e., a clinical diagnosis of knee ligament, meniscal or other intra-articular tibiofemoral or patellofemoral injury within the past 3e10 years that required both medical consultation and resulted in disruption of regular sport participation) during a previous study or, presented to a Sport Medicine Centre with a sportrelated knee injury 3e10 years previously when they were 18 years of age.…”

Lower extremity osteoarthritis: optimising musculoskeletal health is a growing global concern: a narrative review

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