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Lo GH, Richard MJ, McAlindon TE, Kriska AM, Price LL, Rockette-Wagner B, Eaton CB, Hochberg MC, Kent Kwoh C, Nevitt MC, Driban JB. Strength Training Is Associated With Less Knee Osteoarthritis: Data From the Osteoarthritis Initiative. Arthritis Rheumatol 2024; 76:377-383. [PMID: 37870119 PMCID: PMC10922276 DOI: 10.1002/art.42732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/14/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE We aimed to evaluate the relationship of a history of strength training with symptomatic and structural outcomes of knee osteoarthritis (OA). METHODS This study was a retrospective, cross-sectional study within the Osteoarthritis Initiative (OAI), a multicenter prospective longitudinal observational study. Data were collected at four OAI clinical sites: Memorial Hospital of Rhode Island, the Ohio State University, the University of Pittsburgh, and the University of Maryland/Johns Hopkins. The study included 2,607 participants with complete data on strength training, knee pain, and radiographic evidence of knee OA (male, 44.2%; mean ± SD age 64.3 ± 9.0 years; mean ± SD body mass index 28.5 ± 4.9 kg/m2 ). We used a self-administered questionnaire at the 96-month OAI visit to evaluate the exposure of strength training participation during four time periods throughout a participant's lifetime (ages 12-18, 19-34, 35-49, and ≥50 years old). The outcomes (dependent variables) were radiographic OA (ROA), symptomatic radiographic OA (SOA), and frequent knee pain. RESULTS The fully adjusted odds ratios (95% confidence interval) for frequent knee pain, ROA, and SOA among those who participated in strength training any time in their lives were 0.82 (0.68-0.97), 0.83 (0.70-0.99), and 0.77 (0.63-0.94), respectively. Findings were similar when looking at the specific age ranges. CONCLUSION Strength training is beneficial for future knee health, counteracting long-held assumptions that strength training has adverse effects.
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Affiliation(s)
- Grace H. Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX
- Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Medical Center, Houston, TX, USA
| | - Michael J. Richard
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Andrea M. Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lori Lyn Price
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | | | - Charles B. Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI and Department of Epidemiology, School of Public Health of Brown University, Providence, RI
| | - Marc C. Hochberg
- Department of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - C. Kent Kwoh
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
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Jahn J, Ehlen QT, Huang CY. Finding the Goldilocks Zone of Mechanical Loading: A Comprehensive Review of Mechanical Loading in the Prevention and Treatment of Knee Osteoarthritis. Bioengineering (Basel) 2024; 11:110. [PMID: 38391596 PMCID: PMC10886318 DOI: 10.3390/bioengineering11020110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 02/24/2024] Open
Abstract
In this review, we discuss the interaction of mechanical factors influencing knee osteoarthritis (KOA) and post-traumatic osteoarthritis (PTOA) pathogenesis. Emphasizing the importance of mechanotransduction within inflammatory responses, we discuss its capacity for being utilized and harnessed within the context of prevention and rehabilitation of osteoarthritis (OA). Additionally, we introduce a discussion on the Goldilocks zone, which describes the necessity of maintaining a balance of adequate, but not excessive mechanical loading to maintain proper knee joint health. Expanding beyond these, we synthesize findings from current literature that explore the biomechanical loading of various rehabilitation exercises, in hopes of aiding future recommendations for physicians managing KOA and PTOA and athletic training staff strategically planning athlete loads to mitigate the risk of joint injury. The integration of these concepts provides a multifactorial analysis of the contributing factors of KOA and PTOA, in order to spur further research and illuminate the potential of utilizing the body's own physiological responses to mechanical stimuli in the management of OA.
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Affiliation(s)
- Jacob Jahn
- University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Quinn T Ehlen
- University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Chun-Yuh Huang
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, FL 33146, USA
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De Marziani L, Sangiorgio A, Bensa A, Boffa A, Andriolo L, Filardo G. Intra-articular injections in sport-active patients with degenerative cartilage lesions or osteoarthritis of the knee: a systematic review. J Exp Orthop 2023; 10:112. [PMID: 37938446 PMCID: PMC10632330 DOI: 10.1186/s40634-023-00674-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/09/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE The aim of this systematic review was to analyse the available clinical evidence on intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis (OA) in sport-active patients. METHODS A literature search was performed in July 2023 according to the PRISMA guidelines on three electronic databases (PubMed, Cochrane, Web of Science). Studies addressing intra-articular injections for degenerative knee cartilage lesions or knee OA in sport-active patients were included. The Downs and Black's "checklist for measuring quality" was used to evaluate risk of bias and quality of the included studies. RESULTS Only 10 clinical studies for a total of 296 sport-active patients were included, with a publication trend increasing over time. The studies were 9 case series and 1 RCT; 7 studies focused on hyaluronic acid (HA), 2 studies focused on platelet-rich plasma (PRP), while 1 study compared HA and PRP. Overall, safety and positive clinical findings were for both HA and PRP, although not always with satisfactory results in terms of return to sport. The Downs and Black evaluation showed an overall poor quality of the included studies, with an average score of 21.1 points (range 19-25). CONCLUSIONS The available clinical evidence is still limited, with only a few studies published and an overall low-quality of evidence, suggesting a potential role of HA and PRP injections to treat these patients. However, further high-level trials are needed to confirm the real benefits of these treatments for the management of sport-active patients affected by degenerative cartilage lesions or OA of the knee.
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Affiliation(s)
- Luca De Marziani
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alessandro Sangiorgio
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
| | - Alessandro Bensa
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
| | - Angelo Boffa
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luca Andriolo
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Giuseppe Filardo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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Bukhary HA, Basha NA, Dobel AA, Alsufyani RM, Alotaibi RA, Almadani SH. Prevalence and Pattern of Injuries Across the Weight-Training Sports. Cureus 2023; 15:e49759. [PMID: 38046743 PMCID: PMC10689975 DOI: 10.7759/cureus.49759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 12/05/2023] Open
Abstract
Background The prevalence and pattern of injury among weightlifters are insufficiently documented despite these research works. Understanding the injury pattern is crucial for minimizing side effects and maximizing the advantages of weight training. Therefore, the purpose of this study is to determine the frequency and pattern of musculoskeletal injury among weightlifters and to investigate the associations between the prevalence of injury and sociodemographic and training characteristics variables. Methods A descriptive cross-sectional, questionnaire-based study was conducted. An online questionnaire was designed by Google Forms to collect the data by using a self-administered questionnaire. From all health clubs in Taif city, Saudi Arabia, one club was chosen by simple random sampling methodology, where all attendant weightlifters during the study period were contacted to participate in the study. Data was entered on the computer using Microsoft Office Excel 2016 for Windows. Qualitative data was expressed as numbers and percentages, and the Chi-squared test (χ2) was used to assess the relationship between variables. A p-value < 0.05 was considered statistically significant. Results The study included 393 participants, and most respondents fall within the age range of 18-29, accounting for 60.1% of the total. About 27% of participants had a weightlift injury during the last six months. The body parts most injured during weightlifting include the shoulder (7.4%), knee (4.6%), and wrist (3.6%). In terms of the type of injuries sustained, inflammation and pain in the bending of the body (5.9%), torsion (3.6%), ligament tear/muscle tear (3.8%), and stripped-off injuries (2.3%) were reported. Conclusion Musculoskeletal injuries are prevalent among weightlifters due to the nature of the sport and the demands it places on the body. There was no significant association between the injury occurrence with gender, age, or body mass index. However, there was a significant association between the occurrence of injury and weight carried while lifting weights.
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Ding L, Mackey M, Li S. Efficacy of a Neuromuscular Warm-up Program in Reducing the Risk of School Sports Injury among Chinese Children: A Cluster Randomized Controlled Trial. Orthop J Sports Med 2023; 11:23259671231201170. [PMID: 37810741 PMCID: PMC10557415 DOI: 10.1177/23259671231201170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/19/2023] [Indexed: 10/10/2023] Open
Abstract
Background Children who participate in sports have reduced cardiovascular risk, obesity, and type 2 diabetes. However, sports participation also comes with an inherent risk of sports-related injuries. Purpose To examine the efficacy of a school-based neuromuscular warm-up program (NWP) in reducing the risk of school sports injury (SSI) in children and the impact of different levels of compliance on the effectiveness of the program. Study Design Randomized controlled trial; Level of evidence, 1. Methods A total of 421 students from grades 4 to 6 at a single school (age range, 9-14 years) were randomized by grade to an intervention group and a control group. The intervention group participated in a 13-week simplified (8-minute) NWP designed to reduce SSI risk. The control group participated in a standard warm-up of the same length and duration. Exposure, compliance, and injury data were collected via a weekly form. The primary injury outcome was all SSIs. Secondary outcomes included injuries from physical education (PE) and non-PE class, upper and lower extremity injuries, other location injuries, and time-loss injuries. A Poisson regression model using an intent-to-treat analysis was performed to estimate the incidence rate ratio (IRR) for all injuries in the intervention group compared with the control group. To examine the influence of level of compliance, we divided the intervention group into low compliance (participation 1-2 times/wk) and high compliance (participation >2 times/wk) then compared the difference on injury rates (IRs) between these groups and the control group. Results There were significant differences between the intervention and control groups regarding all SSIs (IRR, 0.47; 95% CI, 0.23-0.96; P = .038), PE class injuries (IRR, 0.37; 95% CI, 0.14-0.99; P = .048), and other location injuries (IRR, 0.20; 95% CI, 0.05-0.82; P = .025). The compliance analysis revealed that although the low-compliance group was able to reduce the risk of SSIs (IR, 4.43; 95% CI, 2.49-6.37) compared with the control group (IR, 7.60; 95% CI, 5.61-9.59), the high-compliance group produced a better effect in reducing the SSI risk (IR, 1.80; 95% CI, 0.04-3.56). Conclusion The simplified NWP used in this study was efficacious in the reduction of SSIs in children. Registration ChiCTR2100043875 (Chinese Clinical Trial Registry; http://www.chictr.org.cn).
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Affiliation(s)
- Liyi Ding
- Physical Education College, Shanghai Normal University, Shanghai, China
| | - Marcia Mackey
- Department of Physical Education and Sport, Central Michigan University, Mt Pleasant, Michigan, USA
| | - Shaohua Li
- School of Finance and Business, Shanghai Normal University, Shanghai, China
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Huebner M, Lavallee ME. Arthralgia in female Masters weightlifters. BMC Musculoskelet Disord 2023; 24:670. [PMID: 37620827 PMCID: PMC10464145 DOI: 10.1186/s12891-023-06814-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Arthralgia or joint pain is a heterogeneous condition including organic and nonorganic joint pain. It is common in older populations, particularly in females. There is evidence that menopausal changes are associated with increased prevalence of arthralgia. While physical activities have been recommended to mitigate osteoarthritis (OA) and arthralgia, sport participation also carries risk factors due to excessive loading of some joints and possible injuries. The aim was to evaluate the association of training patterns, prior injuries, and severity of menopausal symptoms with arthralgia in female Masters weightlifters. METHODS Competitive female Masters weightlifters (n=868, 30-78 years) from 30 countries completed an online survey including joint pain for different anatomical sites, weightlifting training and performance, sport history, and menopausal symptoms. Logistic regression models were used to estimate the association of training patterns, prior sport participation, and menopausal symptom severity with arthralgia separately for shoulders, spine, hips, knees, ankles, elbows, and hands. RESULTS Arthralgia was most reported in knees (38.8%), shoulders (29.8%), hands/wrists (28.8%), and hips (24.9%). The prevalence of arthralgia was 51.5% in pre-menopausal women, 62.4% in women post natural menopause and 73.3% in women post medical or surgical menopause. Lifting heavier weights was associated with arthralgia in hips (OR=1.05, p=0.03), knees (OR=1.06, p=0.01), and hands/wrists (OR=1.05, p=0.04), but prior strength training was protective for arthralgia in the shoulders (OR=0.66, p=0.02). Prior injuries and psychological menopausal symptom severity were associated with an increased risk for arthralgia (p<0.01). CONCLUSIONS Arthralgia was common in competitive female weightlifters. Training frequency was not associated with arthralgia, but lifting heavier weights relative to age and body mass was. Prior injuries and menopausal symptoms were associated with arthralgia, but prior strength training was protective of arthralgia in the shoulders. Athletes, coaches and sports medicine professionals should be aware that prevalence of polyarthralgia increases in post-menopausal athletes.
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Affiliation(s)
- Marianne Huebner
- Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA.
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA.
| | - Mark E Lavallee
- Department of Orthopedics, UPMC Central Pennsylvania, Harrisburg, PA, USA
- USA Weightlifting Sports Medicine Society, Colorado Springs, CO, USA
- Executive Medical Committee, International Weightlifting Federation, Lausanne, Switzerland
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Kacprzak B, Rosińska K, Siuba-Jarosz N. Hyalofast Cartilage Repair Surgery with a Full Load-Bearing Rehabilitation Program One Day after Operation Reduces the Time for Professional Athletes to Return to Play. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040804. [PMID: 37109762 PMCID: PMC10145501 DOI: 10.3390/medicina59040804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: This study evaluated the effectiveness of Hyalofast cartilage repair surgery with an early, full load-bearing rehabilitation program one day after the operation for reducing the time needed for professional athletes to return to play. Materials and Methods: This prospective study included 49 patients aged between 19 and 38 years who had undergone surgical reconstruction of cartilage using the microfracture technique combined with a Hyalofast scaffold. All patients were active professional athletes. Early rehabilitation was implemented from the first postoperative day, fully loading the operated limb. A clinical evaluation was based on the KOOS and SF-36 questionnaires used during subsequent follow-up visits. All patients underwent magnetic resonance imaging (MRI) to evaluate the effect of the surgery after one year. Results: The clinical results demonstrated a statistically significant improvement in the number of complaints about pain and in the quality of life of the patients, measured in all of the applied scales, with comparisons made between six months or one year post-surgery and pre-surgery. Importantly for athletes, the parameter related to sports and recreation improved from 14 ± 11.1 to 95 ± 7.7 6 months after surgery and to 99.8 ± 1.8 one year after surgery. The overall quality of life score improved from 30 ± 18 to 88 ± 8.8 one year after surgery. Conclusions: These results show that this approach significantly shortened the time needed for the athletes to return to sports at the same level as before the surgery (athletes returned to sports in approximately 2.5-3 months). The mean follow-up time was 19.75 months. This technique can be considered a viable option for the treatment of cartilage injuries in professional athletes, allowing them to return to play more quickly in a safe and healthy way.
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Affiliation(s)
| | - Karolina Rosińska
- Wolf Project Studio Krzysztof Król, ul. Gdańska 79/D01, 90-612 Łódź, Poland
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Trovato B, Petrigna L, Sortino M, Roggio F, Musumeci G. The influence of different sports on cartilage adaptations: A systematic review. Heliyon 2023; 9:e14136. [PMID: 36923870 PMCID: PMC10009456 DOI: 10.1016/j.heliyon.2023.e14136] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/13/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
Molecular composition and structural adaptation are changes in the cartilage tissue after different stimuli. Sports activities with different loads at different angles, speeds, and intensities can modify the molecular composition of the articular cartilage, hence it is crucial to understand the molecular adaptations and structural modifications generated by sports practice and this review aims to synthesize the current evidence on this topic. A systematic search until July 2022 was performed on the database Medline, Pubmed, Scopus, and Web of Science with a collection of 62,198. After the screening process, the included articles were analyzed narratively. Thirty-one studies have been included in the analysis. From the results emerged that running, swimming, ballet and handball were not correlated with detrimental structural or molecular cartilage adaptation; instead, soccer, volleyball, basketball, weightlifting, climbing, and rowing showed signs of cartilage alteration and molecular adaptation that could be early predictive degeneration's signs. From the included studies it came to light that the regions more interested in morphological cartilage changes were the knee in athletes from different disciplines. In conclusion, different sports induce different cartilage modifications both at a molecular and structural level and it is important to know the risks correlated to sports to implement preventive strategies.
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Affiliation(s)
- Bruno Trovato
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Martina Sortino
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Federico Roggio
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy.,Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, Palermo, 90144, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy.,Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123, Catania, Italy.,Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, 19122, PA, United States
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Dhillon J, Kraeutler MJ, Belk JW, Scillia AJ, McCarty EC, Ansah-Twum JK, McCulloch PC. Effects of Running on the Development of Knee Osteoarthritis: An Updated Systematic Review at Short-Term Follow-up. Orthop J Sports Med 2023; 11:23259671231152900. [PMID: 36875337 PMCID: PMC9983113 DOI: 10.1177/23259671231152900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/08/2022] [Indexed: 03/05/2023] Open
Abstract
Background Some studies have suggested that running increases the risk of knee osteoarthritis (OA), while others believe it serves a protective function. Purpose To perform an updated systematic review of the literature to determine the effects of running on the development of knee OA. Study Design Systematic review; Level of evidence, 4. Methods A systematic review was performed by searching the PubMed, Cochrane Library, and Embase databases to identify studies evaluating the effect of cumulative running on the development of knee OA or chondral damage based on imaging and/or patient-reported outcomes (PROs). The search terms used were "knee AND osteoarthritis AND (run OR running OR runner)." Patients were evaluated based on plain radiographs, magnetic resonance imaging (MRI), and PROs (presence of knee pain, Health Assessment Questionnaire-Disability Index, and the Knee injury and Osteoarthritis Outcome Score). Results Seventeen studies (6 level 2 studies, 9 level 3 studies, and 2 level 4 studies), with 7194 runners and 6947 nonrunners, met the inclusion criteria. The mean follow-up time was 55.8 months in the runner group and 99.7 months in the nonrunner group. The mean age was 56.2 years in the runner group and 61.6 years in the nonrunner group. The overall percentage of men was 58.5%. There was a significantly higher prevalence of knee pain in the nonrunner group (P < .0001). Although 1 study found a significantly higher prevalence of osteophytes in the tibiofemoral (TF) and patellofemoral (PF) joints within the runner group, multiple studies found no significant differences in the prevalence of radiographic knee OA (based on TF/PF joint-space narrowing or Kellgren-Lawrence grade) or cartilage thickness on MRI between runners and nonrunners (P > .05). One study found a significantly higher risk of knee OA progressing to total knee replacement among nonrunners (4.6% vs 2.6%; P = .014). Conclusion In the short term, running is not associated with worsening PROs or radiological signs of knee OA and may be protective against generalized knee pain.
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Affiliation(s)
- Jaydeep Dhillon
- Rocky Vista University College of Osteopathic Medicine, Parker, Colorado, USA
| | - Matthew J Kraeutler
- Department of Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - John W Belk
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Anthony J Scillia
- Department of Orthopaedic Surgery, St Joseph's University Medical Center, Paterson, New Jersey, USA.,Academy Orthopaedics, Wayne, New Jersey, USA
| | - Eric C McCarty
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Patrick C McCulloch
- Department of Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
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d’Errico A, Fontana D, Sebastiani G, Ardito C. Risk of symptomatic osteoarthritis associated with exposure to ergonomic factors at work in a nationwide Italian survey. Int Arch Occup Environ Health 2023; 96:143-154. [PMID: 35900451 PMCID: PMC9823078 DOI: 10.1007/s00420-022-01912-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/08/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The risk of developing osteoarthritis (OA) has been reported to increase with exposure to various ergonomic factors at work, although this finding is still debated in the literature. Aim of this study was to assess the association between prevalence of symptomatic OA and exposure to workplace ergonomic factors assigned through a job-exposures matrix (JEM). METHODS The study population was composed of 24,604 persons of 40-69 years who participated in the National Health Survey 2013 and were employed at that occasion. Exposure to ergonomic factors was assigned to the study population through a JEM constructed from the Italian O*NET database, consisting of 17 physical factors, which were summed and averaged by job title (796 jobs) to obtain a combined exposure index. The outcome was self-reported OA characterized by moderate or severe limitations in daily activities. The relationship between OA prevalence and the combined exposure index in quartiles was examined using robust Poisson regression models adjusted for socio-demographics and potential confounders. RESULTS In the analysis adjusted for age and gender, the risk of OA was increased by approximately 20-30% in the second and third quartiles, and by 80% in the highest exposure quartile, compared to the least exposed, with a risk attenuation by approximately 15-20% controlling for other significant covariates. CONCLUSION Our results support a causal role of exposure to physical factors at work in the development of OA. As OA is associated with a great burden of disability, any effort should be made to reduce workers' exposure to ergonomic factors.
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Affiliation(s)
| | | | | | - Chiara Ardito
- Department of Economics and Statistics "Cognetti de Martiis", University of Turin, Lungo Dora Siena 100A, 10153, Turin, Italy. .,LABORatorio R. Revelli-Centre for Employment Studies, Turin, Italy. .,NETSPAR-Network for Studies on Pensions, Aging and Retirement, Tilburg, The Netherlands.
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11
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Osteoarthritis Risks and Sports: An Evidence-based Systematic Review. Sports Med Arthrosc Rev 2022; 30:118-140. [PMID: 35921595 DOI: 10.1097/jsa.0000000000000351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Regular sports activities are associated with multiple physical and psychological health benefits. However, sports also may lead to injuries and the development of osteoarthritis (OA). This systematic review investigated the association between sports activity, sports type, and the risk of developing OA. METHODS A systematic review was performed by assessing studies that have investigated the risk of OA development in sports. Data extracted included general information, study design, number of participants, related body mass index, sports type, and assessment of OA. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. RESULTS A total of 63 studies were included in this systematic review. The overall Newcastle-Ottawa Scale score was 6.46±1.44 demonstrating a good methodological quality of the articles included in the present study. A total of 628,036 participants were included, with a mean follow-up of 8.0±8.4 years. The mean age of the included athletes was 45.6±15.8, with a mean body mass index of 24.9±2.3 kg/m 2 . CONCLUSION Football and soccer players seem to be at higher risk for the development of OA, although the injury status of the joint should be considered when assessing the risk of OA. High equipment weight and increased injury risk also put military personnel at a higher risk of OA, although elite dancing leads to more hip labral tears. Femoroacetabular impingement was also often diagnosed in ice-hockey players and ballet dancers.
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Palmer D, Cooper D, Whittaker JL, Emery C, Batt ME, Engebretsen L, Schamasch P, Shroff M, Soligard T, Steffen K, Budgett R. Prevalence of and factors associated with osteoarthritis and pain in retired Olympians, with comparison to the general population: part 1 – the lower limb. Br J Sports Med 2022. [DOI: 10.1136/bjsports-2021-104762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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.
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13
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Quaranta M, Riccio I, Oliva F, Maffulli N. Osteoarthritis of the Knee in Middle-age Athletes: Many Measures are Practiced, but Lack Sound Scientific Evidence. Sports Med Arthrosc Rev 2022; 30:102-110. [PMID: 35533062 DOI: 10.1097/jsa.0000000000000341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Osteoarthritis of the knee generally affects individuals from the fifth decade, the typical age of middle-age athletes. In the early stages, management is conservative and multidisciplinary. It is advisable to avoid sports with high risk of trauma, but it is important that patients continue to be physically active. Conservative management offers several options; however, it is unclear which ones are really useful. This narrative review briefly reports the conservative options for which there is no evidence of effectiveness, or there is only evidence of short-term effectiveness.
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Affiliation(s)
- Marco Quaranta
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Ivano Riccio
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Francesco Oliva
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, London
- Faculty of Medicine, School of Pharmacy and Bioengineering, Guy Hilton Research Centre, Keele University, Stoke-on-Trent, England
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14
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Migliorini F, Vecchio G, Pintore A, Oliva F, Maffulli N. The Influence of Athletes' Age in the Onset of Osteoarthritis: A Systematic Review. Sports Med Arthrosc Rev 2022; 30:97-101. [PMID: 35533061 DOI: 10.1097/jsa.0000000000000345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Whether sport participation is a risk factor for osteoarthritis (OA) development or progression is controversial. Mechanical overload, injuries, genetics, and acquired disorders concur to the onset of OA, with high variability between sports and participants. This study investigated the association between participation in specific sports and the risk of developing knee and hip OA in athletes at different ages. We hypothesized that young athletes who are exposed to high levels of physical activities have a greater risk of developing OA. MATERIALS AND METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Google scholar, EMABSE, and Web of Science were accessed in October 2021. No time constrains were used for the search. All the published clinical studies reporting data about relationship between physical activity, OA, and age were included. RESULTS The Newcastle-Ottawa Scale resulted in a final score ≥7 for all studies, attesting good quality of the methodological assessment. Data from 27,364 patients were retrieved. The mean age was 48.2±16.7 years. In all, 21.8% were women. CONCLUSIONS Our systematic review suggests an association between high levels of physical activities and knee and hip OA in men younger than 50 years. People who practice intense physical activity, such as professional athletes or heavy workers, are more prone to develop early-onset OA.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
| | - Gianluca Vecchio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Andrea Pintore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, England
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15
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Migliorini F, Marsilio E, Oliva F, Hildebrand F, Maffulli N. Elderly Runners and Osteoarthritis: A Systematic Review. Sports Med Arthrosc Rev 2022; 30:92-96. [PMID: 35533060 DOI: 10.1097/jsa.0000000000000347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The impact of running on the onset of osteoarthritis (OA) is controversial. This study compared the incidence of OA in elderly runners versus nonrunners. MATERIAL AND METHODS This systematic review was conducted according to the PRISMA guidelines. PubMed, Google scholar, Embase, and Web of Science databases were accessed in January 2022. All the published clinical studies investigating OA onset in runners versus non-runners were considered. Studies reporting data on OA and participants in other sports were excluded. Only studies investigating patients with a mean age older than 55 years were considered. The methodological quality of the articles was evaluated using the Newcastle-Ottawa Scale (NOS). RESULTS Data from 3001 participants and 6674 joints were retrieved. The mean age was 59.4±2.7 years. The mean body mass index was 24.6±2.5 kg/m2. The 5 included articles (963 runners, 2038 nonrunners) did not report significant differences in runners compared with controls. CONCLUSION Middle aged runners did not present greater imaging or clinical signs of OA compared with nonrunner controls. Running at elite or recreational level did not increase the rate of OA progression in individuals older than 50 years.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Aachen, Germany
| | - Emanuela Marsilio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, England
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16
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Migliorini F, Pintore A, Torsiello E, Oliva F, Spiezia F, Maffulli N. Intensive Physical Activity Increases the Risk of Knee and Hip Arthroplasty: A Systematic Review. Sports Med Arthrosc Rev 2022; 30:111-116. [PMID: 35533064 DOI: 10.1097/jsa.0000000000000340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The present study investigated the type of sport and activity level of athletes before they underwent knee and/or hip arthroplasty for osteoarthritis (OA), and compared them with a control group of subjects who did not undergo knee and hip arthroplasty. We hypothesed athletes exposed to high physical loads during sports had the highest risk of developing OA requiring arthroplasty. MATERIALS AND METHODS This systematic review was conducted according to the PRISMA guidelines. All the comparative clinical trials to August 2021 investigating the sport activity level between subjects who underwent arthroplasty versus those who did not undergo arthroplasty for OA were considered. RESULTS Data from 5 studies and 3638 patients were collected. The mean age for both groups was 47.61±15.5 years, and the mean body mass index was 24.6±2.1 kg/m2 17.6% were women. The Newcastle-Ottawa scale attested good quality of the methodology of the investigations included in the present study. CONCLUSION Intense physical exercise, implying a high cumulative number of hours of exercise which can lead to excessive joint overload, in both sexes is associated with greater likelihood of early knee and hip OA which may lead to prosthetic surgery. Moderate and recreational exposure to sport has minor degenerative effects, and is not associated with early onset OA requiring arthroplasty.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
| | - Andrea Pintore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Ernesto Torsiello
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Filippo Spiezia
- Department of Orthopaedics and Trauma Surgery, San Carlo Hospital, Potenza, Italy
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, England
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17
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Carmody S, Anemaat K, Massey A, Kerkhoffs G, Gouttebarge V. Health conditions among retired professional footballers: a scoping review. BMJ Open Sport Exerc Med 2022; 8:e001196. [PMID: 35528132 PMCID: PMC9036466 DOI: 10.1136/bmjsem-2021-001196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/27/2022] Open
Abstract
Objective To conduct a scoping review providing an overview of the health conditions occuring in retired male and female professional footballers, with an emphasis on musculoskeletal, mental, neurocognitive, cardiovascular and reproductive health conditions. Methods In January 2022, a comprehensive systematic literature search in three databases (MEDLINE via PubMed, SPORTDiscus via EBSCOhost and EMBASE) was conducted for common health conditions among retired male and female professional footballers. Primary research studies (full text available online) which described the incidence or prevalence of a health condition (musculoskeletal, mental, neurocognitive, cardiovascular, reproductive) among retired male and female professional footballers were included for review. Case reports, qualitative research and grey literature were omitted. Results In total, 917 eligible articles were identified from the databases, with 41 meeting the eligibility criteria. Osteoarthritis of the hip, knee and ankle were found to be common among retired professional footballers. Mental health symptoms (eg, anxiety, depression) are experienced by retired male and female professional footballers. The incidence of neurocognitive disease appears to be higher among retired male professional footballers than among matched controls. There is very limited evidence examining the presence of health conditions in retired female professional footballers. Conclusion Osteoarthritis of the lower limb, musculoskeletal pain and mental health symptoms are common among retired professional footballers. Knowledge about the occurrence and timing of musculoskeletal, mental health and neurocognitive conditions among retired professional footballers can be used by a wide range of stakeholders to proactively intervene during and after a player’s career to mitigate risk.
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Affiliation(s)
- Sean Carmody
- Amsterdam UMC location University of Amsterdam, Orthopedic Surgery, Meibergdreef 9, Amsterdam, The Netherlands.,Medical Department, Chelsea Football Club, London, UK
| | - Karlijn Anemaat
- Amsterdam UMC location University of Amsterdam, Orthopedic Surgery, Meibergdreef 9, Amsterdam, The Netherlands
| | - Andrew Massey
- Medical Department, Fédération Internationale de Football Association (FIFA), Zurich, Switzerland
| | - Gino Kerkhoffs
- Amsterdam UMC location University of Amsterdam, Orthopedic Surgery, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Sports, Ageing & Vitality, Amsterdam, The Netherlands.,Academic Center for Evidence based Sports medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Amsterdam UMC location University of Amsterdam, Orthopedic Surgery, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands.,Section Sports Medicine, University of Pretoria, Pretoria, South Africa.,Football Players Worldwide (FIFPRO), Hoofddorp, The Netherlands
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18
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A novel approach to studying early knee osteoarthritis illustrates that bilateral medial tibiofemoral osteoarthritis is a heritable phenotype: an offspring study. Rheumatol Int 2022; 42:1063-1072. [PMID: 35460352 DOI: 10.1007/s00296-022-05116-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
To assess the potential of studying offspring of people with and without knee osteoarthritis to understand the risk factors and heritability for knee osteoarthritis. We selected two groups of Osteoarthritis Initiative (OAI) participants from one clinical site: (1) participants with bilateral radiographic medial tibiofemoral osteoarthritis and (2) those without tibiofemoral osteoarthritis. We then invited biological offspring ≥ 18 years old to complete an online survey that inquired about osteoarthritis risk factors and symptoms. Among the survey respondents, we recruited ten offspring of members from each group for a clinic visit with bilateral knee posterior-anterior radiographs and magnetic resonance imaging of the right knee. We established contact with 269/413 (65%) eligible OAI participants. Most (227/269, 84%) had ≥ 1 eligible biological offspring, and 213 (94%) were willing to share information about the new family study with their offspring. Our survey was completed by 188 offspring from 110 OAI participants: mean age of 43.0 (10.4) years, mean body mass index of 23.7 (5.9) kg/m2, 65% female. Offspring obesity (OR = 2.7, 95% CI 1.0-7.3), hypertension (OR = 3.7, 95% CI 1.2-11.3), and Heberden's nodes (OR = 3.6, 95% CI 1.0-13.2) were associated with parental osteoarthritis status; however, adjusted models were not statistically significant. Radiographic tibiofemoral osteoarthritis (16/18 knees vs. 2/20 knees) and meniscal abnormalities (7/9 vs. 2/10 index knees) were more common among offspring with parental osteoarthritis status than not. We established the potential of a novel offspring study design within the OAI, and our results are consistent with bilateral radiographic medial tibiofemoral osteoarthritis being a heritable phenotype of osteoarthritis.
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19
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Webster KE, Hewett TE. Anterior Cruciate Ligament Injury and Knee Osteoarthritis: An Umbrella Systematic Review and Meta-analysis. Clin J Sport Med 2022; 32:145-152. [PMID: 33852440 DOI: 10.1097/jsm.0000000000000894] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/31/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To conduct a systematic review of reviews to summarize the (1) risk for development and (2) prevalence of knee osteoarthritis (OA) after anterior cruciate ligament (ACL) injury and surgical treatment and (3) compare prevalence rates between surgical and nonsurgical treatment of ACL injury. DATE SOURCES Five electronic databases were searched using medical subject heading and text words up to February 2020 to identify English language reviews. STUDY SELECTION Studies were included if they were a systematic review or meta-analysis. DATA EXTRACTION Thirteen eligible reviews were included, and the main outcome extracted was knee OA prevalence or risk data and any meta-analysis results. DATA SYNTHESIS Results from reviews were combined with a summary meta-analysis based on odds ratios (ORs) or proportions. There was a near 7-fold and 8-fold increase in the odds for the development of knee OA post ACL injury [OR = 6.81 (5.70-8.13)] and ACL reconstruction [OR = 7.7, (6.05-9.79)]. Data were too heterogenous to specify a point estimate prevalence for OA after ACL injury, but OA prevalence was estimated at 36% (19.70-53.01) at near 10 years after reconstruction surgery. A significantly higher prevalence of OA was found for those who received surgical treatment at a minimum 10-year follow-up [OR = 1.40 (1.17-1.68)]. CONCLUSIONS This study combines all data from previous systematic reviews into a single source to show that ACL injury markedly increases the risk for development of knee OA, which is likely to be present in the long term in approximately a third of patients who have reconstruction surgery. Surgical treatment does not reduce OA prevalence in the longer term compared with nonsurgical treatment.
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Affiliation(s)
- Kate E Webster
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne Vic, Australia ; and
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20
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The 50 Most Cited Articles on Meniscus Injuries and Surgery from 2000 to 2019 Focus on Arthroscopic Repair or Removal, Originate from Institutions Within the United States and Were Published Before 2010. Arthrosc Sports Med Rehabil 2021; 3:e2103-e2116. [PMID: 34977668 PMCID: PMC8689275 DOI: 10.1016/j.asmr.2021.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 09/22/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose To identify the 50 most cited original articles on meniscus injury and surgery from 2000 to 2019, and to perform a bibliometric analysis of the identified articles. Methods A Clarivate Web of Science search, completed in June 2020, generated a list of the most cited articles related to meniscus research. Articles were sorted by number of times cited, and review articles or those unrelated to the meniscus were removed. Articles were classified as basic science or assigned the appropriate level of evidence. Extracted data included title, authors, journal, year of publication, country/institution of origin, total number of citations, and number of citations per year. Results The final list of 50 included articles with a range of 106 to 490 citations and a mean of 162.34 total or 11.91 citations per year. The most cited articles appeared in 8 of the most influential journals in the field per the Journal Citation Index. Twenty-nine (58%) originated from institutions within the United States, and only 13 (26%) were published in 2010 or later. Overall, 25 (50%) were classified as therapeutic, only 5 (10%) were therapeutic randomized controlled studies, and 17 (34%) were basic science. “Arthroscopic meniscal repair or meniscectomy” appeared most frequently, with 16 (32%) falling into this subclassification. Conclusion This study of the most cited meniscus articles showed a strong predominance for therapeutic studies, studies generated and published within the United States, and studies focused on topics of arthroscopic repair or removal. Overwhelmingly, included articles were published before 2010, affirming the criticism that bibliometric analysis favors older articles. Clinical relevance This study provides information about which articles are driving the field relating to meniscus injuries and meniscus surgery in the last two decades.
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21
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Harr MR, Mansfield CJ, Urbach B, Briggs M, Onate J, Boucher LC. Prevalence and Incidence of Injury during Olympic-style Shooting Events: A Systematic Review. Int J Sports Phys Ther 2021; 16:1235-1249. [PMID: 34631244 PMCID: PMC8486400 DOI: 10.26603/001c.28231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 08/05/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Shooting sports are included in collegiate and Olympic events. However, there is minimal evidence examining injury prevalence and incidence for these athletes. HYPOTHESIS/PURPOSE The purpose of this study was to systematically review the literature to examine the available evidence regarding the incidence, prevalence, and types of injuries that affect athletes in Olympic-style shooting events. STUDY DESIGN Systematic review. METHODS The electronic databases PubMed, Cochrane Library, Cinahl, MEDLINE, and SPORTDiscus were searched utilizing terms related to shooting and injuries. Studies were included if they reported prevalence or incidence of injury in collegiate or Olympic shooting events, and were excluded if inclusion criteria were not met, full text was unavailable, or not in English. Two reviewers independently screened articles in two phases: 1) screening of titles/abstracts 2) full text review. A third reviewer resolved conflicts. RESULTS Nineteen studies were ultimately included. The sports identified were biathlon, rifle, pistol, and shotgun. Shooting events in both winter and summer Olympics had low percentages of injuries compared to other sports. Winter shooting events had a higher percentage of injuries (6.9%) compared to summer (2.3%). In summer, females demonstrated a higher percentage of injuries (6.9%) compared to males (1.7%). In winter, males had a higher percentage of injuries (8.6%) versus females (5.1%). CONCLUSION Injury incidence and prevalence was low for athletes in shooting sports in the Olympics. Injury rate was higher in the winter Olympic shooting events likely from increased physiological demand. With injury surveillance focusing on acute injuries rather than chronic, the number of injuries may be underestimated. Females had higher injury rates than males in the summer Olympics while the opposite was observed in the winter Olympics, likely from sex differences and differences in physiological demand for each event. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
| | - Cody J Mansfield
- School of Health and Rehabilitation Sciences, The Ohio State University; Sports Medicine; The Ohio State University Wexner Medical Center
| | | | - Matt Briggs
- Sports Medicine Research Institute, The Ohio State university Wexner Medical Center; Sports Medicine Research Institute, The Ohio State University Wexner Medical Center; Department of Orthopedics, The Ohio State University Wexner Medical Center
| | - James Onate
- School of Health and Rehabilitation Sciences, The Ohio State University; Sports Medicine Research Institute, The Ohio State University Wexner Medical Center
| | - Laura C Boucher
- School of Health and Rehabilitation Sciences, The Ohio State University; Sports Medicine Research Institute, The Ohio State University Wexner Medical Center
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22
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Mitchell PK, Moffit TJ, Montgomery MM, Pamukoff DN. Running kinetics and femoral trochlea cartilage characteristics in recreational and collegiate distance runners. J Sports Sci 2021; 40:89-95. [PMID: 34494939 DOI: 10.1080/02640414.2021.1976492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Recreational running can benefit knee cartilage, but the relationship between competitive running and knee cartilage is unclear. We compared femoral cartilage between collegiate runners, recreational runners, and controls; and evaluated the association between running amount, running kinetics and femoral cartilage characteristics. Thirty collegiate runners, 30 recreational runners, and 30 controls completed ultrasound imaging of the femoral cartilage and running gait analysis. Outcomes included cartilage thickness, and echo-intensity from the medial and lateral femoral condyles; and the peak external knee flexion (KFM) and knee adduction moments. Cartilage outcomes were compared via one-way MANOVA. The associations between running kinetics, running amount, and femoral cartilage characteristics were assessed via linear regression models adjusted for sex. No differences were found in cartilage outcomes between groups (p = 0.067). Among recreational runners, a larger peak KFM was associated with lower medial femoral cartilage echo-intensity (ΔR2 = 0.176, Δp = 0.014). In collegiate runners, a greater self-reported running amount was associated with higher medial femoral cartilage (ΔR2 = 0.117, Δp = 0.046) and lateral cartilage (ΔR2 = 0.121, Δp = 0.042) echo-intensity. Cartilage did not differ between groups, but the association between running kinetics, running amount, and knee cartilage may vary between collegiate and recreational runners.
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Affiliation(s)
- Peter K Mitchell
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - Tyler J Moffit
- Department of Kinesiology, California State University, Bakersfield, CA, USA
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23
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Cooper DJ, Batt ME, O'Hanlon MS, Palmer D. A Cross-Sectional Study of Retired Great British Olympians (Berlin 1936-Sochi 2014): Olympic Career Injuries, Joint Health in Later Life, and Reasons for Retirement from Olympic Sport. SPORTS MEDICINE-OPEN 2021; 7:54. [PMID: 34331620 PMCID: PMC8325735 DOI: 10.1186/s40798-021-00339-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/20/2021] [Indexed: 11/23/2022]
Abstract
Background The relationship between Olympic career sport injury and the long-term musculoskeletal health of the elite athlete remains unclear. This study describes the lifetime prevalence of medical attention injuries that occurred during training and/or competition as part of the athlete’s Olympic career, reasons for retirement from Olympic sport, and the point prevalence of pain and osteoarthritis (OA) among retired Great Britain’s (GB) Olympians. Methods This cross-sectional study involved distributing a questionnaire to retired GB Olympians who had competed at 36 Olympic Games between Berlin 1936 and Sochi 2014. The questionnaire captured Olympic career injury history (lasting ≥ 1 month), sport exposure, musculoskeletal pain (last 4 weeks), physician-diagnosed OA, and joint replacement. Injury prevalence was calculated for sports with a minimal of 15 respondents. Adjusted odds ratios (aOR) were estimated in logistic regression for pain, OA, and joint replacement. Models were adjusted for age, sex, BMI, and career duration. Results Six hundred fifty (57.8% male; 42.2% female) retired athletes representing 40 sports (29 summer; 11 winter), aged 60.5 years (range 23–97), completed the questionnaire. Overall, 721 injuries (368 athletes) were self-reported equating to a lifetime Olympic career injury prevalence of 56.6%. Injury prevalence was highest in field athletics (81.0%), gymnastics (75.0%), and track athletics (67.7%). Injuries most frequently occurred at the knee (19.0%), lower back (15.4%), and shoulder (11.5%). Of those injured, 19.5% retired from sport due to injury. Pain was most prevalent at the lumbar spine (32.8%), knee (25.3%), and hip (22.5%), and OA at the knee (13.4%), hip (10.4%), and lumbar spine (4.6%). Injury was associated with pain at the hip (aOR 4.88; 95% CI, 1.87–12.72, p = 0.001), knee (aOR 2.35; 95% CI, 1.45–3.81, p = 0.001), and lumbar spine (aOR 2.53; 95% CI, 1.63–3.92, p < 0.001); OA at the hip (aOR 5.97; 95% CI, 1.59–22.47, p = 0.008) and knee (aOR 3.91; 95% CI, 2.21–6.94, p < 0.001); and joint replacement at the hip (aOR 8.71; 95% CI, 2.13–35.63, p = 0.003) and knee (aOR 5.29; 95% CI, 2.39–11.74, p < 0.001). Conclusion The lifetime prevalence of Olympic career injury was 56.6%, with those injured more likely to self-report current pain and/or OA at the hip, knee, and lumbar spine and joint replacement at the hip and knee.
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Affiliation(s)
- Dale J Cooper
- School of Allied Health Professions, Keele University, Keele, Staffordshire, UK.
| | - Mark E Batt
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Mary S O'Hanlon
- Academic Department of Orthopaedics, Trauma and Sports Medicine, University of Nottingham, Nottingham, UK
| | - Debbie Palmer
- Institute for Sport, PE and Health Sciences Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
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Hori M, Terada M, Suga T, Isaka T. Changes in anterior femoral articular cartilage structure in collegiate rugby athletes with and without a history of traumatic knee joint injury following a five-month competitive season. Sci Rep 2021; 11:15186. [PMID: 34312456 PMCID: PMC8313691 DOI: 10.1038/s41598-021-94462-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/12/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to examine anterior femoral cartilage morphology before (pre-season) and after (post-season) a 5-month competitive season in collegiate ruby players with and without a previous history of traumatic injury to ligamentous, meniscus, and/or cartilage structures at the knee joint. Using a prospective cohort design, 42 male collegiate rugby players with a previous history of traumatic intracapsular knee joint injury and 124 players without knee injury history were included in this study. Ultrasonography assessments of anterior femoral cartilage were performed before (pre-season) and following a 5-month athletic season (post-season). Rugby players with a history of traumatic knee joint injury had greater lateral condylar thickness (2.37 ± 0.35 mm, p = 0.03), intercondylar thickness (2.51 ± 0.47 mm, p = 0.03), and partial area (44.67 ± 7.28mm2, p = 0.02) compared to control players (lateral = 2.23 ± 0.35 mm, intercondylar = 2.32 ± 0.47 mm, partial area = 41.60 ± 7.26 mm2), regardless of pre-and post-season assessment time points. Pre-season ultrasonography assessment of lateral condylar thickness (2.34 ± 0.47 mm, p = 0.02), medial condylar thickness (2.05 ± 0.43 mm, p = 0.03), and partial area (44.10 ± 9.23 mm2, p = 0.001) were significantly greater than the post-season ultrasonography assessment time point (lateral = 2.26 ± 0.43 mm, medial = 1.98 ± 0.43 mm, partial area = 42.17 ± 8.82 mm2), regardless of group membership. Rugby players with a history of intracapsular knee joint injury displayed altered anterior femoral cartilage size via ultrasonography assessments. Regardless of a presence of injury history, collegiate rugby players showed a decrease in cartilage thickness and partial area following a 5-month competitive season.
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Affiliation(s)
- Miyuki Hori
- Graduate School of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan.
| | - Tadashi Suga
- Research Organization of Science and Technology, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - Tadao Isaka
- Graduate School of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan.,College of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
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25
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Bjerre-Bastos JJ, Nielsen HB, Andersen JR, Karsdal M, Boesen M, Mackey AL, Byrjalsen I, Thudium CS, Bihlet AR. A biomarker perspective on the acute effect of exercise with and without impact on joint tissue turnover: an exploratory randomized cross-over study. Eur J Appl Physiol 2021; 121:2799-2809. [PMID: 34156534 DOI: 10.1007/s00421-021-04751-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 06/18/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate acute changes in biochemical markers of bone and cartilage turnover in response to moderate intensity exercise with and without joint impact in healthy human subjects. METHODS A randomized, cross-over, exploratory, clinical study was conducted. Twenty healthy subjects with no history of joint trauma completed 30 min interventions of standardized moderate intensity cycling and running as well as a resting intervention 1 week apart. Blood samples were taken immediately before, four times after exercise and again the next day. Urine was sampled, before, after and the next day. On the day of rest, samples were taken at timepoints similar to the days of exercise. Markers of type I (CTX-I), II (C2M, CTX-II) and VI (C6M) collagen degradation, cartilage oligomeric matrix protein (COMP) and procollagen C-2 (PRO-C2) was measured. TRIAL REGISTRATION NUMBER NCT04542655, 02 September 2020, retrospectively registered. RESULTS CTX-I was different from cycling (4.2%, 95%CI: 0.4-8.0%, p = 0.03) and resting (6.8%, 95%CI: 2.9-10.7%, p = 0.001) after running and the mean change in COMP was different from cycling (10.3%, 95%CI: 1.1-19.5%, p = 0.03), but not from resting (8.6%, 95%CI: - 0.7-17.8%, p = 0.07) after running. Overall, changes in other biomarkers were not different between interventions. CONCLUSION In this exploratory study, running, but not cycling, at a moderate intensity and duration induced acute changes in biomarkers of bone and cartilage extra-cellular matrix turnover.
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Affiliation(s)
- Jonathan J Bjerre-Bastos
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
- Nordic Bioscience Clinical Development, Herlev, Denmark.
| | - Henning Bay Nielsen
- Sanos Clinic, Herlev, Denmark
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Mikael Boesen
- Department of Radiology, Bispebjerg Hospital, Copenhagen, Denmark
| | - Abigail L Mackey
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
- Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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26
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Bestwick-Stevenson T, Ifesemen OS, Pearson RG, Edwards KL. Association of Sports Participation With Osteoarthritis: A Systematic Review and Meta-Analysis. Orthop J Sports Med 2021; 9:23259671211004554. [PMID: 34179201 PMCID: PMC8207281 DOI: 10.1177/23259671211004554] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/21/2020] [Indexed: 12/02/2022] Open
Abstract
Background: The association between participating in sport and osteoarthritis is not fully understood. Purpose: To investigate the association between osteoarthritis and participating in sports not listed in previous reviews: American football, archery, baseball, bobsleigh, curling, handball, ice hockey, shooting, skeleton, speed skating, and wrestling. Study Design: Systematic review; Level of evidence, 3. Methods: We searched 4 electronic databases and hand searched recent/in-press editions of relevant journals. The criteria for study selection were case-control studies, cohort studies, nested case-control studies, and randomized trials with a control group that included adults to examine the effect of exposure to any of the included sports on the development of osteoarthritis. Results: The search returned 6197 articles after deduplication. Nine studies were included in the final review, covering hip, knee, and ankle osteoarthritis. There were no studies covering archery, baseball, skeleton, speed skating, or curling. The 6 sports included in the review were analyzed as a collective; the results of the meta-analysis indicated that participation in the sports analyzed was associated with an increased risk of developing osteoarthritis of the hip (relative risk [RR] = 1.67 [95% confidence interval (CI), 1.15-2.41]; P = .04), knee (RR = 1.60 [95% CI, 1.23-2.08]; P < .001), and ankle (RR = 7.08 [95% CI, 1.24-40.51]; P = .03) as compared with controls. Meta-analysis suggested a significantly increased likelihood of developing hip osteoarthritis through participating in wrestling (RR = 1.78 [95% CI, 1.20-2.64]; P = .004) and ice hockey (RR = 1.70 [95% CI, 1.27-2.29]; P < .001), while there was no significant difference through participating in handball (RR = 2.50 [95% CI, 0.85-7.36]; P = .10). Likelihood of developing knee osteoarthritis was significantly increased in wrestling (RR = 2.22 [95% CI, 1.59-3.11]) and ice hockey (RR = 1.52 [95% CI, 1.18-1.96]; both P < .002). According to the meta-analysis, shooting did not have a significant effect on the RR of knee osteoarthritis as compared with other sports (RR = 0.43 [95% CI, 0.06-2.99]; P = .39). Conclusion: The likelihood of developing hip and knee osteoarthritis was increased for ice hockey and wrestling athletes, and the risk of developing hip osteoarthritis was increased for handball athletes. The study also found that participation in the sports examined, as a collective, resulted in an increased risk of developing hip, knee, and ankle osteoarthritis.
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Affiliation(s)
- Thomas Bestwick-Stevenson
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK.,Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - Onosi S Ifesemen
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Richard G Pearson
- Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - Kimberley L Edwards
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK.,Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, University of Nottingham, Nottingham, UK
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Currie GR, Lee R, Palacios-Derflingher L, Hagel B, Black AM, Babul S, Mrazik M, Marshall DA, Emery CA. Reality Check 2: The Cost-Effectiveness of Policy Disallowing Body Checking in Non-Elite 13- to 14-Year-Old Ice Hockey Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126322. [PMID: 34207977 PMCID: PMC8296129 DOI: 10.3390/ijerph18126322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/21/2021] [Accepted: 06/08/2021] [Indexed: 01/23/2023]
Abstract
Sport-related injuries are the leading cause of injury in youth and are costly to the healthcare system. When body checking is disallowed in non-elite levels of Bantam (ages 13–14 years) ice hockey, the injury rate is reduced, but the impact on costs is unknown. This study compared rates of game injuries and costs among non-elite Bantam ice hockey leagues that disallow body checking to those that did not. Methods: An economic evaluation was conducted alongside a prospective cohort study comparing 608 players from leagues where body checking was allowed in games (Calgary/Edmonton 2014–2015, Edmonton 2015–2016) with 396 players from leagues where it was not allowed in games (Vancouver, Kelowna 2014–2015, Calgary in 2015–2016). The effectiveness measure was rate of game injuries per 1000 player-hours. Costs were estimated based on associated healthcare use within the publicly funded healthcare system as well as privately paid healthcare costs. Probabilistic sensitivity analysis was conducted using bootstrapping. Results: Disallowing body checking reduced the rate of injuries by 4.32 per 1000 player-hours (95% CI −6.92, −1.56) and reduced public and total healthcare system costs by $1556 (95% CI −$2478, −$559) and $1577 (95% CI −$2629, −$500) per 1000 player-hours, respectively. These finding were robust in over 99% of iterations in sensitivity analyses in the public healthcare and the total healthcare system perspectives. There was no statistically significant difference in privately paid healthcare costs (−$65 per 1000 player-hours (95% CI −$220, $99)). Interpretation: Disallowing body checking in non-elite 13–14-year-old ice hockey nationally would prevent injuries and reduce public healthcare costs.
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Affiliation(s)
- Gillian R. Currie
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada; (B.H.); (C.A.E.)
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (R.L.); (D.A.M.)
- Correspondence:
| | - Raymond Lee
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (R.L.); (D.A.M.)
| | - Luz Palacios-Derflingher
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (L.P.-D.); (A.M.B.)
| | - Brent Hagel
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada; (B.H.); (C.A.E.)
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (R.L.); (D.A.M.)
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (L.P.-D.); (A.M.B.)
| | - Amanda M. Black
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (L.P.-D.); (A.M.B.)
| | - Shelina Babul
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada;
- BCIRPU, BC Children’s Hospital, Vancouver, BC V6H 3V4, Canada
| | - Martin Mrazik
- Department of Educational Psychology, University of Alberta, Edmonton, AB T6G 2G5, Canada;
| | - Deborah A. Marshall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (R.L.); (D.A.M.)
- McCaig Bone and Joint Health Institute, Calgary, AB T2N 4Z6, Canada
| | - Carolyn A. Emery
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada; (B.H.); (C.A.E.)
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (R.L.); (D.A.M.)
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (L.P.-D.); (A.M.B.)
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Alves-Cardoso F, Assis S. Exploring "wear and tear" of joints and "muscle function" assumptions in skeletons with known occupation at death. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 175:689-700. [PMID: 34013541 DOI: 10.1002/ajpa.24334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/13/2021] [Accepted: 05/02/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Changes in the joints are believed to result from "wear and tear," a consequence of activity, as entheseal changes (EC) result from muscle use. However, clinical data showed that activity does not necessarily increase the likelihood of degenerative joint changes (DJC) and that exercise results in healthier joints. We tested whether individuals with continuous repetitive biomechanical efforts (Group 1) were more likely to exhibit EC and if occupations known to exert strenuous but discontinued efforts (Group 2) would more likely cause DJC. MATERIALS AND METHODS Eighty-nine males with known occupations from Portuguese identified collections were used: shoemakers and carpenters (Group 1), workers (Group 2), and civil servants, and shop assistants as a control group. Major upper and lower limb joints and entheses sites were used. DJC and EC were tested between occupations - while controlling for age (overall approach) - and within occupation (occupation-specific approach). RESULTS The overall approach showed that age - as a covariant - had a significant impact on DJC and EC development (p < 0.05), with occupation being non-significant (p > 0.05) despite the variability in the mean-values of lesions. The occupation-specific approach showed a significant variability of DJC and EC correlations, within and between occupations, with no clear trend of DJC and EC development according to occupation. DISCUSSION The results showed that exploring overall patterns might conceal occupation-specific joint and muscle use, emphasizing age as a major contributor of changes; and that the occupation-specific approach highlighted particular aspects associated with occupations, allowing for a more informative assessment of strenuous repetitive or discontinuous activity-related technical gestures and their impact on skeletal biology.
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Affiliation(s)
- Francisca Alves-Cardoso
- Laboratório de Antropologia Biológica e Osteologia Humana (LABOH), Centro em Rede de Investigação em Antropologia (CRIA), Faculdade de Ciências Sociais e Humanas, Universidade NOVA de Lisboa (FCSH/NOVA), Lisbon, Portugal
| | - Sandra Assis
- Laboratório de Antropologia Biológica e Osteologia Humana (LABOH), Centro em Rede de Investigação em Antropologia (CRIA), Faculdade de Ciências Sociais e Humanas, Universidade NOVA de Lisboa (FCSH/NOVA), Lisbon, Portugal.,CIAS-Research Center for Anthropology and Health, University of Coimbra, Coimbra, Portugal
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29
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Freiberg A, Bolm-Audorff U, Seidler A. The Risk of Knee Osteoarthritis in Professional Soccer Players. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:49-55. [PMID: 33759745 DOI: 10.3238/arztebl.m2021.0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 02/26/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND We address the question whether professional soccer players with and without macroinjury of the knee joint are at an elevated risk for knee osteoarthritis. METHODS A systematic review with meta-analyses was conducted. The study protocol was prospectively registered (registration number CRD42019137139). The MEDLINE, EMBASE, and Web of Science databases were searched for relevant publications; in addition, forward searching was performed, and the listed references were considered. All steps of the process were undertaken independently by two reviewers, and any discordances were resolved by consensus. For all publications whose full text was included, the methods used were critically evaluated. The quality of the evidence was judged using the GRADE criteria. RESULTS The pooled odds ratio for objectively ascertained osteoarthrosis of the knee was 2.25 (95% confidence interval [1.41-3.61], I2 = 71%). When only radiologically ascertained knee osteoarthrosis was considered, the odds ratio was 3.98 [1.34; 11.83], I2 = 58%). The pooled risk estimator in studies in which knee joint macroinjury was excluded was 2.81 ([1.25; 6.32], I2 = 71%). CONCLUSION A marked association was found between soccer playing and knee osteoarthritis in male professional soccer players. For female professional soccer players, the risk of knee osteoarthritis could not be assessed because of the lack of data. Knee injuries seem to play an important role in the development of knee osteoarthritis in professional soccer players.
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Affiliation(s)
- Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden; Division of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South Hesse, Wiesbaden; Extraordinary Chair of Occupational Medicine, University of Gießen
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30
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Mean femoral cartilage thickness is higher in athletes as compared with sedentary individuals. Knee Surg Sports Traumatol Arthrosc 2021; 29:1206-1214. [PMID: 32671433 DOI: 10.1007/s00167-020-06146-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/10/2020] [Indexed: 11/11/2022]
Abstract
PURPOSE It is unclear how high-intensity physical activity (HIPA) affects the knee joint, specifically the femoral cartilage (FC). Therefore, the aims of this study were to evaluate FC thickness via ultrasound among elite athletes involved in different types of HIPA, and to determine whether there is a correlation between serum cartilage oligomeric matrix protein (sCOMP) and rectus femoris (RF) thickness. METHOD A total of 132 male individuals participated in this study and were assigned to two groups, the sedentary (n = 43, 23.9 ± 3.7) and athlete groups (n = 89, 22.7 ± 4.6), which did not significantly differ in age. The athletes were elite and performed HIPA during sports such as volleyball (n = 20), soccer (n = 21), basketball (n = 28), and weightlifting (n = 20). RF thickness and three (mid-point) measurements were obtained for each knee. The mean FC thickness for each knee was defined as the sum of the medial, lateral condyles, and intercondylar areas. Blood samples for sCOMP analyses were also obtained. RESULTS All the measurements of the FC of both knees were significantly higher in the athletes than in the sedentary individuals (p < 0.001 and p = 0.001). The mean right and left FC values were also higher in the athletes (p < 0.001). Multiple linear regression analysis showed that participation in sporting activities was a significant predictor associated with the right and left mean FC thickness (p < 0.001 for both). No significant differences in the sCOMP levels were found between the two groups. CONCLUSION It was found that the mean FC was higher among athletes than among sedentary individuals. As a result, it is suggested that sports' participation is an independent factor associated with the right and left mean FC thickness. LEVEL OF EVIDENCE III.
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31
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Roberts HM, Griffith-McGeever CL, Owen JA, Angell L, Moore JP, Thom JM. An exploratory study to investigate the association between age, physical activity, femoral trochlear cartilage thickness and biomarkers of tissue metabolism in adult males. Eur J Appl Physiol 2021; 121:1871-1880. [PMID: 33713200 PMCID: PMC8192398 DOI: 10.1007/s00421-021-04655-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 02/25/2021] [Indexed: 11/27/2022]
Abstract
Purpose To investigate the association between age, physical activity, femoral trochlear cartilage thickness and biomarkers of tissue metabolism in a cross-sectional sample of adult males. This study utilizes several emerging biomarkers that have been associated with early joint degenerative changes; serum COMP (cartilage oligomeric matrix protein), HA (hyaluronan) and lubricin. Methods Eighty-one males (age: mean (range): 43(18–70) years; body mass index: 25.2 (21.0–30.6) kg/m2) volunteered. Resting serum COMP, HA and lubricin concentrations were determined via commercially available enzyme-linked immunosorbent assay (ELISA) and femoral trochlear cartilage thickness via supra-patellar ultrasound imaging. Physical activity levels were assessed using questionnaires. Statistical analyses were performed using correlation and regression analyses. Results Age was correlated with lateral trochlear cartilage thickness (r = − 0.372; p < 0.01) and serum COMP (r = 0.342; p < 0.01). 7-day physical activity was correlated with serum COMP (r = 0.357, p < 0.01), and 12-month physical activity with both lateral trochlear cartilage thickness (r = 0.340, p = 0.01) and serum HA (r = 0.296, p < 0.05). Regression analyses revealed that age significantly accounted for the variability in lateral cartilage thickness and serum COMP, following the adjustment for potential cofounders. However, the association between age and lateral trochlear cartilage thickness was not moderated by physical activity levels (all p > 0.05). Conclusion This study indicates that older age may be associated with thinner lateral trochlear cartilage and higher cartilage turnover. Being physically active may also be positive for lateral trochlear cartilage thickness. However, overall, both age and physical activity level only account for a small amount of the variability in cartilage thickness and serum biomarkers.
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Affiliation(s)
- Harry M Roberts
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK. .,School of Biosciences and Medicine, University of Surrey, The Leggett Building, Daphne Jackson Road, Guildford, GU2 7WG, UK.
| | - Claire L Griffith-McGeever
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Julian A Owen
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Lewis Angell
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Jonathan P Moore
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK
| | - Jeanette M Thom
- School of Sport, Health and Exercise Sciences, Physical Activity for Health and Well Being (PAWB) Research Group, Bangor University, Bangor, UK.,School of Medical Sciences, University of New South Wales, Sydney, Australia
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Krieger EAG, Karam FC, Soder RB, da Silva JLB. Prevalence of patellar chondropathy on 3.0 T magnetic resonance imaging. Radiol Bras 2020; 53:375-380. [PMID: 33304004 PMCID: PMC7720672 DOI: 10.1590/0100-3984.2019.0105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To establish the prevalence of patellar chondropathy using 3T magnetic resonance imaging (MRI) and to correlate the findings with individual features such as gender, age, and body mass index. Materials and Methods Data consisted of collecting 3T MRIs of patients’ knees obtained between October 2016 and September 2017, comprising a period of 12 months. These MRIs were assessed by an experienced musculoskeletal radiologist who confirmed the presence of patellar chondropathy and, when present, rated the finding into the four grades ascribed by the International Cartilage Repair Society. Results A total number of 291 patients were assessed during the period with 389 MRI scans. Of those patients, 308 (79.2%) were diagnosed with patellar chondropathy, while 81 (20.8%) were not. Chondropathy was more prevalent in the female gender, in subjects above 40 years of age, and in obese patients. When the results were weighed in International Cartilage Repair Society classification, the milder grades (1 and 2) were seen in younger men (< 30 years of age), while the more severe grades (3 and 4) were mostly present in females, those above 40 years of age, and in obese patients. Conclusion There was a high prevalence of patellar chondropathy in patients who had undergone high-field knee MRIs (79.2%), being highest in the female gender and in subjects above 40 years of age. The most prevalent group was graded as 4 by the International Cartilage Repair Society classification.
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Affiliation(s)
- Eduardo André Gomes Krieger
- Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Francisco Consoli Karam
- Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Ricardo Bernardi Soder
- Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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Lawrence EA, Hammond CL, Blain EJ. Potential of zebrafish as a model to characterise MicroRNA profiles in mechanically mediated joint degeneration. Histochem Cell Biol 2020; 154:521-531. [PMID: 32935147 PMCID: PMC7609428 DOI: 10.1007/s00418-020-01918-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 12/19/2022]
Abstract
Mechanically mediated joint degeneration and cartilage dyshomeostasis is implicated in highly prevalent diseases such as osteoarthritis. Increasingly, MicroRNAs are being associated with maintaining the normal state of cartilage, making them an exciting and potentially key contributor to joint health and disease onset. Here, we present a summary of current in vitro and in vivo models which can be used to study the role of mechanical load and MicroRNAs in joint degeneration, including: non-invasive murine models of PTOA, surgical models which involve ligament transection, and unloading models based around immobilisation of joints or removal of load from the joint through suspension. We also discuss how zebrafish could be used to advance this field, namely through the availability of transgenic lines relevant to cartilage homeostasis and the ability to accurately map strain through the cartilage, enabling the response of downstream MicroRNA targets to be followed dynamically at a cellular level in areas of high and low strain.
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Affiliation(s)
- Elizabeth A Lawrence
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK.
| | - Chrissy L Hammond
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK
| | - Emma J Blain
- Biomechanics and Bioengineering Centre Versus Arthritis, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, UK
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Bennett HJ, Valenzuela KA, Lynn SK, Weinhandl JT. Foot Rotation Gait Modifications Affect Hip and Ankle, But Not Knee, Stance Phase Joint Reaction Forces During Running. J Biomech Eng 2020; 143:1085853. [DOI: 10.1115/1.4047994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Indexed: 11/08/2022]
Abstract
AbstractAlterations of foot rotation angles have successfully reduced external knee adduction moments during walking and running. However, reductions in knee adduction moments may not result in reductions in knee joint reaction forces. The purpose of this study was to examine the effects of internal and external foot rotation on knee, hip, and ankle joint reaction forces during running. Motion capture and force data were recorded of 19 healthy adults running at 3.35 m/s during three conditions: (1) preferred (normal) and with (2) internal and (3) external foot rotation. Musculoskeletal simulations were performed using opensim and the Rajagopal 2015 model, modified to a two degree-of-freedom knee joint. Muscle excitations were derived using static optimization, including muscle physiology parameters. Joint reaction forces (i.e., the total force acting on the joints) were computed and compared between conditions using one-way analyses of variance (ANOVAs) via statistical parametric mapping (SPM). Internal foot rotation reduced resultant hip forces (from 18% to 23% stride), while external rotation reduced resultant ankle forces (peak force at 20% stride) during the stance phase. Three-dimensional and resultant knee joint reaction forces only differed at very early and very late stance phase. The results of this study indicate, similar to previous findings, that reductions in external knee adduction moments do not mirror reductions in knee joint reaction forces.
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Affiliation(s)
- Hunter J. Bennett
- Department of Human Movement Sciences, 2016 Student Recreation Center, Old Dominion University, Norfolk, VA 23529
| | - Kevin A. Valenzuela
- Department of Kinesiology, HHS2-203, California State University, Long Beach, CA 90840
| | - Scott K. Lynn
- Department of Kinesiology, KHS 224, California State University, Fullerton, CA 92834
| | - Joshua T. Weinhandl
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, 322 HPER Building, Knoxville, TN 37996-2700
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Ahmad Z, Murakami AM, Engebretsen L, Jarraya M, Roemer FW, Guermazi A, Kompel AJ. Knee cartilage damage and concomitant internal derangement on MRI in athletes competing at the Rio de Janeiro 2016 Summer Olympics. Eur J Radiol Open 2020; 7:100258. [PMID: 32984449 PMCID: PMC7495057 DOI: 10.1016/j.ejro.2020.100258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 08/24/2020] [Indexed: 01/01/2023] Open
Abstract
Cartilage damage is frequently observed on MRI in Olympic Athletes. Patellofemoral cartilage damage is most common and associated with certain sports including volleyball and weightlifting. Meniscal tears are associated with localized cartilage damage. Trend for prevalence of cartilage damage to increase with increasing age of the athlete.
Purpose To report the MRI patterns of knee cartilage damage and concomitant internal derangement in athletes participating at the Rio de Janeiro 2016 Olympic Games. Methods Knee MRIs obtained at the core imaging facility of the International Olympic Committee were blindly, retrospectively reviewed by a board-certified musculoskeletal radiologist for meniscal, ligamentous, and tendon abnormalities. Cartilage assessment was based on the modified Outerbridge criteria. Results Of 122 athletes who received a knee MRI, 64 (52.4 %) had cartilage damage. Cartilage damage was more prevalent in the patellofemoral compartment (52 athletes, 42.6 %), followed by lateral (23 athletes, 18.9 %) and medial tibiofemoral compartments (12 athletes, 9.8 %). Patellofemoral cartilage damage was most prevalent in beach-volleyball (100 %), followed by volleyball (8 athletes, 66.7 %) and weightlifting (7 athletes, 70 %). Patellofemoral cartilage damage was most prevalent with quadriceps (8 athletes, 72.7 %) and patellar tendinosis (11 athletes, 61.1 %). Medial and lateral tibiofemoral cartilage damage was significantly associated with medial (8 athletes, 29.6 %) and lateral meniscal tears (16 athletes, 55.2 %), respectively. There was a trend for the percentage of athletes with cartilage damage to increase with age. Conclusion The majority of athletes at the 2016 Rio Summer Olympics who had a knee MRI showed cartilage damage. Patellofemoral compartment cartilage damage was most common and frequently observed in certain sports including volleyball, beach volleyball, and weightlifting. Overuse in these sports can contribute to patellofemoral cartilage damage and subsequent development of anterior knee pain. Cartilage damage was also observed with concomitant meniscal tears and older age.
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Affiliation(s)
- Zohaib Ahmad
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States
| | - Akira M Murakami
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland.,Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Orthopedic Surgery, Oslo University Hospital, University of Oslo, Norway
| | - Mohamed Jarraya
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States.,Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States.,Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg, & Universitätsklinikum Erlangen, Erlangen, Germany
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States.,Department of Radiology, VA Boston Health System, Boston, MA, United States
| | - Andrew J Kompel
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States
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Vogel R, Zdravkovic V, Badulescu M, Puskás GJ, Jost B. Comparing major joint injuries, interventions and late sequelae in elite male handball players with an age-matched control group. SPORTVERLETZUNG-SPORTSCHADEN 2020; 35:136-141. [PMID: 32820477 DOI: 10.1055/a-1143-7559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Handball is a contact sport which involves throwing and jumping, exposing players to serious physical stress. There is a high risk of injuries leading to possible long-term sequelae. The aim of this study was to assess the incidence of musculoskeletal injuries in elite male handball players compared with an age-matched control group. PATIENTS AND METHODS Former elite handball players, who had played on the Swiss national team between 1980 and 1985, answered a questionnaire about injuries, surgical interventions and their current health status. A total of 34 athletes were compared with 58 age-matched volunteers, who only engaged in recreational sports or no sports at all. RESULTS The mean age of the athletes was 58.4 years (range 52-68 years) and did not differ significantly from the mean age of the control group of 58.7 years (range 53-69 years). In the control group, 70 % engaged in recreational sports. There was no statistical difference regarding the life-long incidence of shoulder injuries and surgical interventions, sequelae or persistent shoulder pain. Athletes had more interventions after elbow injuries (0.09 vs. 0, p = 0.047), but the difference with respect to chronic pain or late sequelae was not statistically significant. For knee injuries, there were no significant differences regarding the incidence of injuries or interventions, the prevalence of secondary consequences or persistent pain. Concerning the foot and ankle, there was a significantly higher incidence of injuries (0.5 vs. 0.03, p < 0.001) and interventions (0.5 vs. 0.09, p < 0.001) in athletes, but no statistical difference regarding sequelae or persistent pain. Overall quality of life had identical ratings in both groups (athletes mean 85.9 %, controls mean 85.8 %). DISCUSSION Top handball players did not sustain more shoulder or knee injuries than the age-matched control group. The elbow was more at risk in these top athletes, but long-term consequences appeared to be less severe. The most distinctive difference was seen in foot and ankle injuries. CONCLUSIONS A career as an elite handball player had no adverse effect on the overall quality of life of elite handball players 25 to 30 years after retiring from professional sports.
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Gignac MAM, Irvin E, Cullen K, Van Eerd D, Beaton DE, Mahood Q, McLeod C, Backman CL. Men and Women's Occupational Activities and the Risk of Developing Osteoarthritis of the Knee, Hip, or Hands: A Systematic Review and Recommendations for Future Research. Arthritis Care Res (Hoboken) 2020; 72:378-396. [PMID: 30762317 PMCID: PMC7065017 DOI: 10.1002/acr.23855] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 02/12/2019] [Indexed: 12/24/2022]
Abstract
Objective To systematically review the evidence for an increased risk of osteoarthritis in the hip, knee, hand, wrist, finger, ankle, foot, shoulder, neck, and spine related to diverse occupational activities of men and women and to examine dose‐response information related to the frequency, intensity, and duration of work exposures and the risk of osteoarthritis (OA). Methods Established guidelines for systematic reviews in occupational health and safety studies were followed. MEDLINE, Embase, CINAHL, and Cochrane Library were searched from inception to December 2017. Studies were reviewed for relevance, quality was appraised, and data were extracted and synthesized. Results Sixty‐nine studies from 23 countries yielded strong and moderate evidence for lifting, cumulative physical loads, full‐body vibration, and kneeling/squatting/bending as increasing the risks of developing OA in men and women. Strong and moderate evidence existed for no increased risk of OA related to sitting, standing, and walking (hip and knee OA), lifting and carrying (knee OA), climbing ladders (knee OA), driving (knee OA), and highly repetitive tasks (hand OA). Variability in dose‐response data resulted in an inability to synthesize these data. Conclusion Evidence points to the potential for OA occupational recommendations and practice considerations to be developed for women and men. However, research attention is needed to overcome deficits in the measurement and recall of specific work activities so that recommendations and practice considerations can provide the specificity needed to be adopted in workplaces.
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Affiliation(s)
- Monique A M Gignac
- Institute for Work and Health and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Emma Irvin
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Kim Cullen
- Institute for Work and Health, Toronto, and School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Quenby Mahood
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Chris McLeod
- Institute for Work and Health, Toronto, Ontario, and School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine L Backman
- University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada
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Particulate matter exposure aggravates osteoarthritis severity. Clin Sci (Lond) 2020; 133:2171-2187. [PMID: 31696218 DOI: 10.1042/cs20190458] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/14/2019] [Accepted: 10/18/2019] [Indexed: 12/25/2022]
Abstract
Several diseases have been linked to particulate matter (PM) exposure. Outdoor activities, such as road running or jogging, are popular aerobic exercises due to few participatory limitations. Osteoarthritis (OA) is a progressive degenerative joint disease, usually observed at age 40, and not noticed before pain or diagnosis. Although exercise has health benefits, it is unclear whether outdoor jogging in higher PM (standard reference material 1649b, SRM 1649b) concentration environments could affect OA development or severity. Hence, a PM exposure monosodium iodoacetate (MIA)-induced OA animal jogged model was established for investigation. Results showed that high doses of PM (5 mg) significantly increased pro-inflammatory factors such as tumor necrosis factor α (TNF-α), interleukin (IL)-1β, and IL-6, and M1 macrophages in the lung region, also obtained in systemic IL-6 and TNF-α expressions in this MIA-OA rat model. Moreover, levels of osteocalcin, cartilage oligomeric matrix protein (COMP), and N-telopeptides of type I collagen were especially influenced in MIA+PM groups. Morphological and structural changes of the knee joint were detected by micro-computed tomography images (micro-CT) and immunohistochemistry. MIA + PM rats exhibited severe bone density decrease, cartilage wear, and structure damages, accompanied by lower levels of physical activity, than the sham group and groups receiving MIA or PM alone. The findings suggest that the severity of OA could be promoted by PM exposure with a PM concentration effect via systemic inflammatory mechanisms. To the best of our knowledge, this is the first study to provide direct effects of PM exposure on OA severity.
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Almaawi A, Awwad W, Bamugaddam A, Alasheikh M, Muaddi M, Almutair O, Alomar AZ. Prevalence of knee injuries among male college students in Riyadh, Kingdom of Saudi Arabia. J Orthop Surg Res 2020; 15:126. [PMID: 32238180 PMCID: PMC7110648 DOI: 10.1186/s13018-020-01638-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The knee is considered the most common injured joint between young sport participants. However, there is lack of proper prevalence estimation in our population. The purpose of this study was to identify the prevalence of knee injuries among male college students and to observe the demographic data associated with it. Our secondary objective was to evaluate the awareness and knowledge about these injuries. METHODS This is a cross-sectional study. A survey was distributed to collect the data among male college students, King Saud University, Riyadh, Saudi Arabia. Out of 688 students who participated and completed the questionnaire, a total of 482 were considered valid and met the inclusion criteria. Data were analyzed using Statistical Package for Social Sciences (SPSS). RESULTS The overall prevalence of knee injury was 23.2% (n = 112). Most of them injured during sport activities especially soccer and 68.7% involved in a non-contact mechanism of injury. Among those who went to a hospital mostly were diagnosed as contusion (31.4%) then as meniscus tear, ACL, and collateral ligament injury, respectively. Majority was treated conservatively and only 10.7% needed surgery surprisingly. There was no statistically significant difference between those who are injured and whether they were warmed up and stretched or not (P = 0.619). Low level of knowledge about knee injuries was noticed among the participants 57.7%. CONCLUSION Our study has highlighted the high prevalence of knee injuries and the need to raise the level of awareness and knowledge about these injuries in our population. Soccer was the most common sport associated with knee injuries; most of these injuries were treated conservatively.
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Affiliation(s)
- Abdulaziz Almaawi
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Waleed Awwad
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Azzam Bamugaddam
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Muath Alasheikh
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Omar Almutair
- Orthopedic Surgery Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulaziz Z Alomar
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Abstract
Osteoarthritis (OA) is a worldwide endemic and debilitating disease. Previously thought to simply be damaged from "wear and tear," OA is now understood to be a complex interaction of local and systemic factors. This article reviews the pathology, symptoms, diagnosis, and various conservative, surgical, and novel treatments of OA.
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Affiliation(s)
- Benjamin Abramoff
- Department of PM&R, University of Pennsylvania, Penn Medicine Rittenhouse, 1800 Lombard Street, Philadelphia, PA 19146, USA
| | - Franklin E Caldera
- Department of PM&R, University of Pennsylvania, Penn Medicine Rittenhouse, 1800 Lombard Street, Philadelphia, PA 19146, USA.
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Lien-Iversen T, Morgan DB, Jensen C, Risberg MA, Engebretsen L, Viberg B. Does surgery reduce knee osteoarthritis, meniscal injury and subsequent complications compared with non-surgery after ACL rupture with at least 10 years follow-up? A systematic review and meta-analysis. Br J Sports Med 2019; 54:592-598. [DOI: 10.1136/bjsports-2019-100765] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 12/14/2022]
Abstract
ObjectiveWe compared long-term follow-up from surgical versus non-surgical treatment of ACL rupture regarding radiographic knee osteoarthritis (OA), secondary surgery, laxity and patient-reported outcome measures (PROMs).DesignSystematic review and meta-analysis.Data sourcesEmbase, MEDLINE, CINAHL and the Cochrane Library databases.Eligibility criteria for selecting studiesStudies directly comparing the minimally invasive surgical (arthroscopy or miniarthrotomy) and non-surgical treatment of ACL rupture with at least 10 years of follow-up in adult patients were included.ResultsFive studies met the eligibility criteria. A meta-analysis revealed a higher risk of radiographic knee OA and a lower risk of secondary meniscal surgery for patients in the surgical group. The risk of graft rupture/secondary ACL revision and secondary ACL reconstruction was equal in the surgical and non-surgical groups. Knee laxity was lower among patients in the surgical group in four studies. No difference was found in the PROMs (ie, International Knee Documentation Committee, Tegner, Knee Injury and Osteoarthritis Outcome, and Lysholm scores).ConclusionThe risk of radiographic knee OA was higher, but the risk of secondary meniscal injury was lower 10 years after surgical treatment of ACL rupture. The risk of graft rupture/secondary ACL revision or secondary reconstruction was unrelated to treatment type. The degree of knee laxity was reduced after surgical treatment in comparison with non-surgical treatment, while PROMs were similar. However, due to the methodological challenges highlighted in this systematic review, these findings must be interpreted with caution.PROSPERO registration numberCRD42019119468
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Davies MAM, Kerr ZY, DeFreese JD, Arden NK, Marshall SW, Guskiewicz KM, Padua DA, Pietrosimone B. Prevalence of and Risk Factors for Total Hip and Knee Replacement in Retired National Football League Athletes. Am J Sports Med 2019; 47:2863-2870. [PMID: 31498654 DOI: 10.1177/0363546519870804] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Osteoarthritis is a substantial cause of disability. Joint replacement prevalence relates to the burden of severe osteoarthritis, and identifying risk factors for end-stage disease may indicate intervention opportunities. American football has high youth and elite participation, and determining risk factors for severe osteoarthritis may support future morbidity prevention. PURPOSE To (1) determine the prevalence of hip and knee replacement in retired National Football League (NFL) athletes, (2) examine risk factors for replacement, and (3) identify the association between knee injuries and knee replacement. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Retired NFL athletes who participated in a general health survey were included. This historical cohort included those playing between 1929 and 2001. The association between self-reported playing or injury history, and replacement after retirement, was assessed with prevalence ratios (PRs). Models were adjusted for potential confounders of age and weight. RESULTS Data for 2432 retired male NFL players (69.3% response rate) who had participated in football for a mean 15.2 years were included, in which 277 players reported replacement after retirement (11.4%). More participants reported knee replacement (7.7%) than hip replacement (4.6%). The majority of participants reported previous severe knee injury (53%), and the most prevalent was meniscal tear (32.2%). In multivariable models, age (10-year increase, PR, 2.23; 95% CI, 1.99-2.51), current weight (PR, 1.10; 95% CI, 1.06-1.14), and reporting 1 (PR, 1.78; 95% CI, 1.14-2.77), 2 (PR, 1.91; 95% CI, 1.16-3.15), or ≥3 knee injuries (PR, 3.44; 95% CI, 2.33-5.09) were associated with knee replacement. Age (10-year increase, PR, 1.86; 95% CI, 1.59-2.18), linemen (PR, 1.62; 95% CI, 1.03-2.55), and reporting 1 (PR, 1.72; 95% CI, 1.05-2.80), 2 (PR, 2.77 95% CI, 1.58-4.84), or ≥3 (PR, 2.44; 95% CI, 1.52-3.91) hip injuries were associated with hip replacement. Each reported knee injury type was cross-sectionally associated with replacement after retirement (P < .05). CONCLUSION Knee replacement was more prevalent than hip replacement. Risk factors differed between the hip and the knee, with age and severe joint injury associated with hip and knee replacement, weight with knee replacement, and playing position associated with hip replacement. Joint injury and weight management may be prevention opportunities to reduce morbidity and end-stage osteoarthritis in this population.
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Affiliation(s)
- Madeleine A M Davies
- Department of Health, University of Bath, Bath, UK.,The Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Center for the Study of Retired Athletes, University of North Carolina, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - J D DeFreese
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Center for the Study of Retired Athletes, University of North Carolina, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nigel K Arden
- The Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK
| | - Stephen W Marshall
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Center for the Study of Retired Athletes, University of North Carolina, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kevin M Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Center for the Study of Retired Athletes, University of North Carolina, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Darin A Padua
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian Pietrosimone
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
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Knee Osteoarthritis and Meniscal Injuries in the Runner. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-00235-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ter Heegde F, Luiz AP, Santana-Varela S, Chessell IP, Welsh F, Wood JN, Chenu C. Noninvasive Mechanical Joint Loading as an Alternative Model for Osteoarthritic Pain. Arthritis Rheumatol 2019; 71:1078-1088. [PMID: 30638309 PMCID: PMC6618037 DOI: 10.1002/art.40835] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 01/08/2019] [Indexed: 02/06/2023]
Abstract
Objective Mechanisms responsible for osteoarthritic (OA) pain remain poorly understood, and current analgesic therapies are often insufficient. This study was undertaken to characterize and pharmacologically test the pain phenotype of a noninvasive mechanical joint loading model of OA, thus providing an alternative murine model for OA pain. Methods The right knees of 12‐week‐old male C57BL/6 mice were loaded at 9N or 11N (40 cycles, 3 times per week for 2 weeks). Behavioral measurements of limb disuse and mechanical and thermal hypersensitivity were acquired before mechanical joint loading and monitored for 6 weeks postloading. The severity of articular cartilage lesions was determined postmortem with the Osteoarthritis Research Society International scoring system. To assess efficacy of various treatments for pain, 9N‐loaded mice were treated for 4 weeks with diclofenac (10 mg/kg), gabapentin (100 mg/kg), or anti–nerve growth factor (anti‐NGF) (3 mg/kg). Results Mechanical hypersensitivity and weight bearing worsened significantly in 9N‐loaded mice (n = 8) and 11N‐loaded mice (n = 8) 2 weeks postloading, compared to baseline values and nonloaded controls. Maximum OA scores of ipsilateral knees confirmed increased cartilage lesions in 9N‐loaded mice (mean ± SEM 2.8 ± 0.2; P < 0.001) and 11N‐loaded mice (5.3 ± 0.3; P < 0.001), compared to nonloaded controls (1.0 ± 0.0). Gabapentin and diclofenac restored pain behaviors to baseline values after 2 weeks of daily treatment, and gabapentin was more effective than diclofenac. A single injection of anti‐NGF alleviated nociception 2 days after treatment and remained effective for 2 weeks, with a second dose inducing stronger and more prolonged analgesia. Conclusion Our findings show that mechanical joint loading induces OA lesions in mice and a robust pain phenotype that can be reversed using analgesics known to alleviate OA pain in patients. This establishes the use of mechanical joint loading as an alternative model for the study of OA pain.
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Zhu Z, Aitken D, Cicuttini F, Jones G, Ding C. Ambulatory activity interacts with common risk factors for osteoarthritis to modify increases in MRI-detected osteophytes. Osteoarthritis Cartilage 2019; 27:650-658. [PMID: 30654117 DOI: 10.1016/j.joca.2018.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 12/10/2018] [Accepted: 12/24/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the longitudinal association between objectively measured ambulatory activity (AA) and knee MRI-detected osteophytes (OPs), and to test whether this relationship was modified by common risk factors for OA including sex, obesity, disease severity and knee injury history. METHODS 408 community-dwelling adults aged 51-81 years were assessed at baseline and 2.7 years. T1-weighted fat-suppressed MRI was used to evaluate knee OPs at both time points. AA was assessed at baseline by pedometers and categorized as: less active (≤7499 steps per day), moderately active (7500-9999 steps per day) and highly active (≥10,000 steps per day). RESULTS Statistically significant interactions were detected between knee OA risk factors and AA on increases in MRI-detected OPs (all P < 0.05). In stratified analyses, being moderately active, compared to being less active, was protective against an increase in MRI-detected OPs (score change of ≥1) in females (relative risk (RR) = 0.42, 95%CI, 0.25-0.70, P < 0.01), those who were obese (RR = 0.50, 95%CI, 0.30-0.83, P < 0.01), those with radiographic OA (ROA) (RR = 0.68, 95%CI, 0.47-0.97, P = 0.02) and those with a history of knee injury (RR = 0.27, 95%CI, 0.08-0.88, P = 0.02) in almost every knee compartment, after adjustment for confounders. No statistically significant associations were found in males, non-obese, non-ROA or non-injury groups. CONCLUSIONS Being moderately active is protective against an increase in MRI-detected OPs in females, those with ROA, those who are obese and those with a history of knee injury. These findings suggest that being moderately active is beneficial for individuals who are at higher risk of knee OA.
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Affiliation(s)
- Z Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - D Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliate Hospital of Anhui Medical University, Hefei, China.
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The " Journal of Functional Morphology and Kinesiology" Journal Club Series: Highlights on Recent Papers in Exercise and Osteoarthritis. J Funct Morphol Kinesiol 2019; 4:jfmk4010007. [PMID: 33467322 PMCID: PMC7739403 DOI: 10.3390/jfmk4010007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 12/20/2022] Open
Abstract
We are glad to introduce the eleventh Journal Club. This edition is focused on several relevant studies published in the last years in the field of exercise and osteoarthritis, chosen by our Editorial Board members and their colleagues. We hope to stimulate your curiosity in this field and to share with you the passion for sport seen also from the scientific point of view. The Editorial Board members wish you an inspiring lecture.
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O'Neill TW, McCabe PS, McBeth J. Update on the epidemiology, risk factors and disease outcomes of osteoarthritis. Best Pract Res Clin Rheumatol 2018; 32:312-326. [PMID: 30527434 DOI: 10.1016/j.berh.2018.10.007] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 10/12/2018] [Accepted: 10/12/2018] [Indexed: 12/20/2022]
Abstract
Osteoarthritis (OA) is the most frequent form of arthritis and a leading cause of pain and disability worldwide. OA can affect any synovial joint, although the hip, knee, hand, foot and spine are the most commonly affected sites. Knowledge about the occurrence and risk factors for OA is important to define the clinical and public health burden of the disease to understand mechanisms of disease occurrence and may also help to inform the development of population-wide prevention strategies. In this article, we review the occurrence and risk factors for OA and also consider patient-reported outcome measures that have been used for the assessment of the disease.
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Affiliation(s)
- Terence W O'Neill
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Paul S McCabe
- Royal Oldham Hospital, Pennine Acute NHS Trust, Rochdale Rd, Oldham OL1 2JH, UK
| | - John McBeth
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
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Madaleno FO, Santos BA, Araújo VL, Oliveira VC, Resende RA. Prevalence of knee osteoarthritis in former athletes: a systematic review with meta-analysis. Braz J Phys Ther 2018; 22:437-451. [PMID: 29636304 PMCID: PMC6235824 DOI: 10.1016/j.bjpt.2018.03.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/13/2018] [Accepted: 03/22/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prevalence of knee osteoarthritis in former athletes is still unclear. OBJECTIVE To investigate prevalence of knee osteoarthritis in former athletes. Moreover, the secondary aim was to investigate whether poor methodological quality of included studies, different diagnosis criteria for knee osteoarthritis, different sports modality or sex impact on overall estimated prevalence of knee osteoarthritis in former athletes. METHODS Searches on MEDLINE, EMBASE, AMED, SPORTDiscus and CINAHL from the earliest record to February 2018 and hand-searching identified studies investigating prevalence of knee osteoarthritis in former athletes. Meta-analysis was conducted and the GRADE system summarized strength of the current recommendations. Sensitivity analyses investigated whether methodological quality, diagnostic criteria, type of sports or sex impacted on the overall estimated prevalence in former athletes. This review was registered at PROSPERO (CRD42016050903). RESULTS Fifteen studies were included and pooling of 3100 participants estimated overall prevalence of knee osteoarthritis in former athletes of 30.0% (95% CI: 20.0 to 40.0%). The strength of the current recommendations was low-quality. Sensitivity analyses suggested that different diagnostic criteria for knee osteoarthritis and type of sports may impact on the overall estimated prevalence. CONCLUSIONS Prevalence of knee osteoarthritis in former athletes was 30.0%. Researchers, clinicians and policymakers should be careful about potential prevalence differences among type of sports and diagnostic criteria. Current low-quality evidence shows that future high-quality studies are likely to impact on the estimated prevalence.
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Affiliation(s)
- Fernanda O Madaleno
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruna A Santos
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vanessa L Araújo
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vinicius C Oliveira
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Renan A Resende
- Department of Physical Therapy, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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de Araujo FX, de Castro MP, Schell MS, Vidmar MF, Marques FO, Pierri CAA, Silva MF. Twenty-Year Follow-up Study Comparing Operative Versus Nonoperative Treatment of Anterior Cruciate Ligament Ruptures in High-Level Athletes: Letter to the Editor. Am J Sports Med 2018; 46:NP55-NP57. [PMID: 30169143 DOI: 10.1177/0363546518788318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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