Remarkably high prevalence of overuse-related knee complaints and MRI abnormalities in youth competitive alpine skiers: a descriptive investigation in 108 athletes aged 13–15 years

Abstract

Background/aimCompetitive alpine skiing is known to be associated with a high risk of traumatic knee injuries. However, little is known about the exact prevalence of knee overuse injuries and their associations with structural changes, particularly in youth skiers. Accordingly, the aim of the present study was to describe the overuse-related knee complaints and MRI abnormalities in a cohort of youth skiers around the growth spurt.Methods108 youth competitive alpine skiers aged 13–15 years were examined using an MRI of both knees, an interview on existing knee complaints and a physical examination. As a common baseline for these assessments, skiers were prospectively monitored by the use of the Oslo Sports Trauma Research Centre questionnaire on health problems over a period of 12 months preceding the major investigations.Results88.0% of the youth skiers showed at least one MRI abnormality in the knees. The most frequent findings were distal femoral cortical irregularities (63%), focal periphyseal oedema (FOPE) zones (25.0%) and cartilage lesions (18.5%). 47.2% of all skiers suffered from at least one overuse-related knee complaint during the 12 months preceding the MRI examination, mostly at the distal and proximal patellar tendon. However, despite a certain association with corresponding MRI abnormalities, the sensitivity of an MRI-based detection of such complaints was strongly limited.ConclusionYouth competitive alpine skiers suffer from a remarkably large number of knee overuse injuries. Accordingly, an effective prevention strategy should include a systematic screening of clinical complaints, ideally already starting around the growth spurt.

Thigh muscle activation patterns and dynamic knee valgus at peak ground reaction force during drop jump landings: Reliability, youth competitive alpine skiing-specific reference values and relation to knee overuse complaints

“…25 Moreover, the occurrence of substantial knee overuse complaints within the 12 months prior to the main experiment was surveyed by the use of (i) the Oslo Sports Trauma Research Centre (OSTRC) questionnaire on health problems, 26 and (ii) retrospective supplementary interviews directly before the experiment, a methodological procedure described in more detail elsewhere. 11 The division into substantial and non-substantial knee complaints was based on the OSTRC severity score, where substantial defines as moderate or severe reductions in training volume, moderate or severe reductions in sports performance, or complete inability to participate in sport. 26 On average, males were 0.2 y older than females (14.9 ± 0.5 y vs. 14.7 ± 0.6 y).…”

“…With respect to overuse injuries, the knees (and especially the patella tendon) are most affected in both youth and elite skiers. [9][10][11] A major concern pertains to youth skiers around the growth spurt, whose bodies are still maturing and, therefore, are especially sensitive to unfavourable loads. 11,12 Moreover, in under 16 years old (U16) skiers, overuse injuries revealed to be more frequent in females than in males.…”

“…[9][10][11] A major concern pertains to youth skiers around the growth spurt, whose bodies are still maturing and, therefore, are especially sensitive to unfavourable loads. 11,12 Moreover, in under 16 years old (U16) skiers, overuse injuries revealed to be more frequent in females than in males. 9 In skiing, up to 1.75 times the body weight can act on each leg, 13 and the knee joint is inevitably subjected to extreme kinematics, including high degrees of flexion and valgus.…”

Common Biochemical and Magnetic Resonance Imaging Biomarkers of Early Knee Osteoarthritis and of Exercise/Training in Athletes: A Narrative Review

“…Our knowledge is perplexed by the contrasting effects of regular, moderate joint-loading exercise and those overloading the joints or being excessive. Some believe that sports with repetitive and excessive joint loading likely increase the risk of articular tissue degradation, resulting in the clinical symptoms of OA [7,[21][22][23][24][25][26]. In contrast to age-dependent OA, the disease process occurs more rapidly in the athlete's joint subjected to high mechanical stress and is associated with an accelerated progression [23,[25][26][27][28][29][30].…”

“…Some believe that sports with repetitive and excessive joint loading likely increase the risk of articular tissue degradation, resulting in the clinical symptoms of OA [7,[21][22][23][24][25][26]. In contrast to age-dependent OA, the disease process occurs more rapidly in the athlete's joint subjected to high mechanical stress and is associated with an accelerated progression [23,[25][26][27][28][29][30]. For example, in soccer players, the incidence of OA is 5-12 times more frequent than in the general population and it is diagnosed 4-5 years earlier [31,32].…”