Prevalence of and factors associated with osteoarthritis and pain in retired Olympians compared with the general population: part 1 – the lower limb

Abstract

ObjectivesThis study aims (1) to determine the prevalence of lower limb osteoarthritis (OA) and pain in retired Olympians; (2) to identify factors associated with their occurrence and (3) to compare with a sample of the general population.Methods3357 retired Olympians (median 44.7 years) and 1735 general population controls (40.5 years) completed a cross-sectional survey. The survey captured demographics, general health, self-reported physician-diagnosed OA, current joint/region pain and injury history (lasting >1 month). Adjusted OR (aOR) compared retired Olympians with the general population.ResultsThe prevalence of (any joint) OA in retired Olympians was 23.2% with the knee most affected (7.4%). Injury was associated with increased odds (aOR, 95% CI) of OA and pain in retired Olympians at the knee (OA=9.40, 6.90 to 12.79; pain=7.32, 5.77 to 9.28), hip (OA=14.30, 8.25 to 24.79; pain=9.76, 6.39 to 14.93) and ankle (OA=9.90, 5.05 to 19.41; pain=5.99, 3.84 to 9.34). Increasing age and obesity were also associated with knee OA and pain. While the odds of OA did not differ between Olympians and the general population, Olympians with prior knee and prior hip injury were more likely than controls with prior injury to experience knee (1.51, 1.03 to 2.21 (Olympians 22.0% vs controls 14.5%)) and hip OA (4.03, 1.10 to 14.85 (Olympians 19.1% vs Controls 11.5%)), respectively.ConclusionsOne in four retired Olympians reported physician-diagnosed OA, with injury associated with knee, hip and ankle OA and pain. Although overall OA odds did not differ, after adjustment for recognised risk factors Olympians were more likely to have knee and hip OA after injury than the general population, suggesting injury is an occupational risk factor for retired Olympians.

Prevalence of and factors associated with osteoarthritis and pain in retired Olympians compared with the general population: part 2 – the spine and upper limb

“…Recruitment of retired Olympians was carried out Globally through World Olympians Association (WOA) and International Olympic Committee (IOC) platforms, National Olympians Associations (NOA) and via the OLY database. [1,11] General population group recruitment (controls), was conducted in three phases: 1) study promotion via WOA and IOC communication channels; 2) using Olympian 'buddies' where Olympians were asked to recruit a non-Olympian friend of the same age (+ 5yrs) and sex, and 3) by members of the research group through academic and industry organisations, and local regional public leisure, medical and community centres. [1] Detailed participant study information, including data handling and confidentiality, was provided at the start of the survey.…”

“…[1,11] General population group recruitment (controls), was conducted in three phases: 1) study promotion via WOA and IOC communication channels; 2) using Olympian 'buddies' where Olympians were asked to recruit a non-Olympian friend of the same age (+ 5yrs) and sex, and 3) by members of the research group through academic and industry organisations, and local regional public leisure, medical and community centres. [1] Detailed participant study information, including data handling and confidentiality, was provided at the start of the survey. It was explicitly outlined that by completing and submitting the questionnaire, the participants' were consenting that their information would be used anonymously for the study.…”

“…The Olympian survey was a web-based password protected survey [11] The general population survey was open access and similar to the Olympic questionnaire contained four main sections: (1) baseline demographics, (2) sport participation and self-reported injury history details, (3) self-reported current musculoskeletal health, and, (4) current general health, and quality of life. [1] Baseline questions requested demographics such as age and sex. Current height (cm) and weight (kg) were collected to calculate body mass index (BMI kg/m2).…”

“…The presence of joint pain was established using a validated question 'Do you currently experience pain, for most days of the last month, in this joint'. [1,11,12] Selfreported physician-diagnosed osteoarthritis was ascertained by asking 'Have you ever been diagnosed with osteoarthritis in any of your joints by a medical professional. If yes, please complete details by joint'.…”

“…In addition, the odds of suffering knee and hip OA after injury were greater for Olympians compared with the general population. [1] To date, most retired athlete studies have focused on factors and outcomes associated OA and pain in isolated body joints of the lower limb, such as the hip and knee. [2][3][4][5][6] Conversely, while a few retired athlete studies have reported the prevalence of pain and OA in the spine [7,8,9] and the upper limb [8] there has been no focus on the factors influencing these outcomes in these body regions in retired elite athletes.…”