Long‐term evolution of cartilage abnormalities and osteophytes in the fingers of elite sport climbers: A cross‐sectional 10‐year follow‐up study

Abstract

The sequelae of high mechanical stress to the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints of the fingers in elite sport climbers and its contribution to the development of osteoarthritis are still relatively unknown. The purpose of this study was to investigate the evolution of cartilage abnormalities of the PIP and DIP joints, as well as the progress of osteophytes, in the fingers of elite sport climbers with a minimum of 25 years of climbing history over the time period of the last 10 years. Moreover, their actual cartilage abnormalities and osteophyte occurrence were compared to non-climbing age-matched controls. Thirty-one elite male sport climbers and 15 male non-climbers underwent a sonographic examination of the PIP and DIP joint cartilage and osteophyte thickness in the frontal and sagittal plane of digits II-V of both hands. The same cohort had already been measured with an identical protocol 10 years earlier (follow-up rate of 100%). Compared to the baseline assessment 10 years earlier, the cartilage thickness of sport climbers has significantly decreased; however, it was still greater than in age-matched controls. Moreover, sport climbers showed significantly higher relative frequencies of osteophyte occurrence than non-climbers (all fingers and joints). Nevertheless, despite a substantial (and compared to baseline a further increased) occurrence of osteophytes in elite sport climbers, there was no association between the radiological signs of osteoarthritis and pain within the last six months prior the follow-up investigation. KEYWORDSAthletes; overuse; hand; finger joint; osteoarthritis; climbing Highlights. Long-term elite climbers show thicker cartilage and occurrence of Osteophytes in their fingers (especially Digit III) compared to controls already early in their career. . Later occurrence of osteophytes increases (especially Digit II and IV) and cartilage decreases but is still thicker compared to controls. No association between those findings and pain was found.

A Life Dedicated to Climbing and Its Sequelae in the Fingers—A Review of the Literature

“…With further climbing years, the cartilage, however, decreased over a decade but was still thicker as compared with non-climbing controls. Furthermore, a clear correlation to pain could not be found [ 13 ], and the question of whether these findings were early signs of osteoarthritis or just mechano-adaptations could not be conclusively clarified. In contrast, several other studies have found clear signs of osteoarthritis in the fingers of climbers.…”

“…Furthermore, a height- and weight-matched 40-year-old non-climbing male surgeon was evaluated for a direct comparison of the presented pictures. We waivered a perfect age matched control, because no significant increases in size (osteophytes, bones, cartilage, pulley, flexor tendons and palmar plates) over a 10-year follow-up period could be found in the fingers of non-climbers in previously published studies [ 11 , 12 , 13 ].…”

Evaluation of finger cartilage composition in recreational climbers with 7 Tesla T2 mapping magnetic resonance imaging

“…This is associated with a high incidence of acute injuries, such as finger pulley rupture, which represents the most common climbing injury ( 9 ). Concerning joint tissue adaptation as a response to repetitive stress and loading, cartilage alterations and osteoarthritis (OA) development in the finger joints have been examined in several studies but an association between climbing activity and early OA development could not be shown ( 10 – 13 ). Young top athletes may develop tissue adaptations such as an increase in cartilage thickness and cortical thickness ( 13 , 14 ) at an early stage of their career.…”

“…Concerning joint tissue adaptation as a response to repetitive stress and loading, cartilage alterations and osteoarthritis (OA) development in the finger joints have been examined in several studies but an association between climbing activity and early OA development could not be shown ( 10 – 13 ). Young top athletes may develop tissue adaptations such as an increase in cartilage thickness and cortical thickness ( 13 , 14 ) at an early stage of their career. Studies by Pastor et al focussed on long-term climbing athletes performing at a high level and investigated a possible connection between cartilage and cortical thickness, osteophyte development and pain symptoms in follow-up studies ( 12 , 13 ).…”

“…Young top athletes may develop tissue adaptations such as an increase in cartilage thickness and cortical thickness ( 13 , 14 ) at an early stage of their career. Studies by Pastor et al focussed on long-term climbing athletes performing at a high level and investigated a possible connection between cartilage and cortical thickness, osteophyte development and pain symptoms in follow-up studies ( 12 , 13 ). Studies investigating a potential impact on finger cartilage for recreational climbing activities at an early stage are pending.…”