1
|
Hernandez SG, Mannix R, Kerr ZY, Lempke LB, Chandran A, Walton SR, DeFreese JD, Echemendia RJ, Guskiewicz KM, McCrea MA, Meehan Iii WP, Brett BL. Longitudinal characterization of pain interference and influential factors in former National Football League (NFL) players over a 19-year period: an NFL-LONG Study. THE JOURNAL OF PAIN 2024:104577. [PMID: 38796128 DOI: 10.1016/j.jpain.2024.104577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/23/2024] [Accepted: 05/18/2024] [Indexed: 05/28/2024]
Abstract
Previous studies on pain experiences in retired contract sport athletes have been cross-sectional, leaving gaps in our understanding of the evolution of pain interference (PI) and factors that influence trajectories decades after sport discontinuation. This study investigated the longitudinal course of PI in former male NFL players over a 19-year period following sport discontinuation and examined factors influencing overall levels and trajectories of PI. Former NFL players completed health surveys in 2001, 2010, and 2019, with PI ratings measured using the 36-Item Short Form Health Survey (2001 and 2010) and the Patient-Reported Outcomes Measurement Information System (2019). Unconditional latent growth curve models analyzed overall PI severity and trajectories. Conditional LGCMs explored the influence of musculoskeletal injuries, osteoarthritis (OA), and depression diagnosis on PI. Over 19 years (N=338; mean age=48.96±9.35), PI significantly increased (slope=0.179, p<0.001; mean PROMIS PI t-scores 2001=54.19, 2010=54.64, 2019=57.38). Cumulative musculoskeletal injuries (B=0.092, p<0.001) and baseline depression diagnosis (B=4.463, p<0.001) were associated with overall PI levels, but not change over time. OA was significantly associated with overall PI levels (B=6.536, p<0.001) and trajectory (B=-0.253, p<0.001); those endorsing OA in 2001 had lower PI increases over 19 years. Body region of injury and level of play during injuries mirrored overall injury effects. PI mildly increased over 19 years, with multiple factors independently influencing overall PI levels. Enhancing former contact sport athlete daily functionality may be achieved through holistic biopsychosocial interventions addressing musculoskeletal injuries, OA, and depression. Future research should identify factors influencing elevated trajectories of long-term PI post-sport discontinuation. PERSPECTIVE: This study assessed pain interference (PI) in former NFL athletes over two-decades, revealing notable inter-individual variability in trajectories over time. Musculoskeletal injuries, depression, and osteoarthritis correlated with overall PI. Prevention and intervention in these three areas presents potential to improve disruptions in daily living due to pain in former athletes.
Collapse
Affiliation(s)
- Sean G Hernandez
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA; Department of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Landon B Lempke
- Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan USA
| | - Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; Datalys Center for Sports Injury Research and Prevention, Indianapolis, USA
| | - Samuel R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - J D DeFreese
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ruben J Echemendia
- Psychological and Neurobehavioral Associates, Inc, State College, Pennsylvania, USA; Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Kevin M Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - William P Meehan Iii
- Sports Medicine Division, Boston Children's Hospital, Boston, Massachusetts, USA; Department of Pediatrics and Orthopedics, Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin L Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| |
Collapse
|
2
|
McClure M, Cooke B, Elphingstone J, Schick S, Paul K, Jardaly A, Brabston E, Momaya A, Ponce B. Orthopedic consequences of modern gladiators: a systematic review of lower extremity musculoskeletal issues in retired NFL players. PHYSICIAN SPORTSMED 2023; 51:539-548. [PMID: 36062826 DOI: 10.1080/00913847.2022.2119897] [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: 04/26/2022] [Accepted: 08/26/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The stressors that National Football League (NFL) athletes face are well-described and documented with regard to multisystem afflictions and injury prevalence. However, the majority of literature discusses the short-term effects rather than long-term outcomes of playing professional football. The purpose of this study was to characterize the long-term musculoskeletal issues in the retired NFL population. METHODS Publications from CENTRAL, Scopus, Medline, PubMed, Embase, and Google Scholar were searched from database inception to February 2021. A total of 9 cohort studies evaluating lower extremity arthritis in retired NFL athletes were included for review. Two reviewers extracted data from the individual studies, including demographic information (age, body mass index, length of career, position), injury descriptions (location of injury, number of injuries, diagnoses), and procedure (total knee and or hip arthroplasty) frequency. RESULTS Arthritis in retired NFL players was more than twice as prevalent than the general United States male population (95% CI: 2.1-2.3). Ankle osteoarthritis was directly correlated with the number of foot and ankle injuries. Players <50 years of age had a 16.1 and 13.8 times higher risk of undergoing TKA and THA, respectively, when compared to the general population. In older age groups, this trend held with retired NFL players being at least 4.3 and 4.6 times more likely than members of the general population to undergo TKA and THA, respectively. CONCLUSION This review demonstrates that the effects of NFL-related lower extremity injuries extend beyond the players' careers and present a higher risk for early-onset osteoarthritis and overall frequency of undergoing total knee and hip arthroplasty.
Collapse
Affiliation(s)
- Mark McClure
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brett Cooke
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joseph Elphingstone
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Samuel Schick
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kyle Paul
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Achraf Jardaly
- The Hughston Clinic, Columbus GA, USA
- The Hughston Foundation, Columbus, GA, USA
| | - Eugene Brabston
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amit Momaya
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brent Ponce
- The Hughston Clinic, Columbus GA, USA
- The Hughston Foundation, Columbus, GA, USA
| |
Collapse
|
3
|
Kuenze C, Pietrosimone B, Currie KD, Walton SR, Kerr ZY, Brett BL, Chandran A, DeFreese JD, Mannix R, Echemendia RJ, McCrea M, Guskiewicz KM, Meehan WP. Joint Injury, Osteoarthritis, and Cardiovascular Disease Risk Factors in Former National Football League Athletes: An NFL-LONG Study. J Athl Train 2023; 58:528-535. [PMID: 36645831 PMCID: PMC10496448 DOI: 10.4085/1062-6050-0437.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
CONTEXT Individuals with lower extremity osteoarthritis (OA) have a 25% greater risk of cardiovascular disease (CVD) than those without OA. The prevalence of traumatic joint injuries among National Football League (NFL) players exposes these athletes to an elevated risk for OA and potentially a greater risk of cardiovascular risk factors (CRFs) and CVD. OBJECTIVES To examine the associations between a history of lower extremity joint injury, lower extremity OA, and the prevalence of CRFs and CVD among former NFL athletes. DESIGN Cross-sectional study. PATIENTS OR OTHER PARTICIPANTS Former NFL players completed a comprehensive health questionnaire that was used in an ongoing study, the Neurologic Function Across the Lifespan: A Prospective, Longitudinal, and Translational Study for Former NFL Players (NFL-LONG). A subsample of 1738 former players reported lifetime medical diagnoses including CVD or CRFs. MAIN OUTCOME MEASURE(S) Crude and adjusted prevalence ratios (PRsadj) characterized the associations between CVD or CRFs and injury, OA diagnosis, or both among athletes who reported (1) no history of lower extremity joint injury or surgery and no diagnosed OA, (2) a history of lower extremity joint injury or surgery and no diagnosed OA, and (3) a history of lower extremity joint injury or surgery and diagnosed OA. RESULTS Neither a history of lower extremity joint injury (PRadj = 1.34; 95% CI = 0.86, 2.07) nor a history of lower extremity joint injury and diagnosed OA (PRadj = 1.41; 95% CI = 0.89, 2.25) was significantly associated with CVD. However, CRFs were 30% and 53% more prevalent in former players with lower extremity joint injury and no diagnosed OA (PRadj = 1.30; 95% CI = 1.12, 1.50) and those with lower extremity joint injury and diagnosed OA (PRadj = 1.53; 95% CI = 1.31, 1.78), respectively, versus athletes with no history of either condition. CONCLUSIONS The prevalence of CRFs was highest among former NFL athletes with a history of lower extremity joint injury and diagnosed OA. These findings provide insight regarding the potential pathways to chronic diseases that may be initiated by joint injury early in life.
Collapse
Affiliation(s)
| | - Brian Pietrosimone
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill
| | | | - Samuel R. Walton
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill
| | - Zachary Y. Kerr
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill
| | | | - Avinash Chandran
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - J. D. DeFreese
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill
| | | | - Ruben J. Echemendia
- University of Missouri–Kansas City
- University Orthopedics Center Concussion Clinic, State College, PA
| | | | - Kevin M. Guskiewicz
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill
| | | |
Collapse
|
4
|
Hong CC, Calder J. The Burden of the "Simple Ankle Sprains": A Review of the Epidemiology and Long-Term Impact. Foot Ankle Clin 2023; 28:187-200. [PMID: 37137618 DOI: 10.1016/j.fcl.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Lateral ankle sprain (LAS) is not as simple as it was believed to be as it has substantial negative impacts on the active sporting population. The negative impact on physical function, quality of life (QoL) and economic burden is significant with increased risk of reinjury, development of chronic lateral ankle instability and posttraumatic ankle osteoarthritis resulting in functional deficits, decreased QoL and chronic disabilities. Economic burden from a societal perspective demonstrated notably higher indirect costs from productivity loss. Preventative interventions with early surgery for a selective cohort of active sporting population may be considered to mitigate morbidities associated with LAS.
Collapse
Affiliation(s)
- Choon Chiet Hong
- Fortius Clinic (FIFA Medical Centre of Excellence), 17 Fitzhardinge Street, London, W1H 6EQ, UK; Department of Orthopaedic Surgery, National University Hospital of Singapore, 1E, Kent Ridge Road, Singapore 119228, Singapore.
| | - James Calder
- Fortius Clinic (FIFA Medical Centre of Excellence), 17 Fitzhardinge Street, London, W1H 6EQ, UK; Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| |
Collapse
|
5
|
Monteleone G, Tramontana A, Sorge R, Tiloca A, Roselli M. Ankle sprain and podoscopic footprint pattern in female volleyball players. Acta Orthop Belg 2023; 89:141-145. [PMID: 37294998 DOI: 10.52628/89.1.10704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Ankle sprain (AS) is the most common sports injury that can be complicated by chronic joint instability. The aim of this study was to examine the relationship between foot types and the ankle sprain events suffered during the sport career in female volleyball players. In this retrospective study, we randomly selected 98 female volleyball players competing in several divisions. Data were obtained from self-administered questionnaires in which the athlete noted data about volleyball practice, whether they had had ankle sprains and the number of these events. Plantar footprint was photographed by a plantoscope classifying each foot as normal, flat or cavus (196 feet). Of the 196 feet, 145 (74.0%) were normal, 8 (4.1%) were flat 43 and (21.9%) were cavus. Thirthy-five athletes reported at least one AS during volleyball practice. In total 65 sprain injuries were reported (35 to the right side and 30 to the left side). In 22 ankles (14 right, 8 left) sprain reinjure (AS >1) have been reported. A higher AS reinjury rate is correlated to the cavus footprint pattern (p = 0,005). Cavus foot associates to a higher risk of reinjury for ankle sprains in female volleyball players. Knowing the athletes which are more likely to sustain a reinjure may be helpful for the orthopedic surgeon to plan preventive strategies.
Collapse
|
6
|
Du X. FUNCTIONAL TRAINING ON ANKLE SPRAIN REHABILITATION IN SOCCER PLAYERS. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228062022_0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
ABSTRACT Introduction An ankle sprain is a common soccer injury. Functional training is used to rehabilitate muscle strength with undiscovered benefits on soccer players’ recovery. Objective Explore the functional training effects on ankle injury recovery in soccer players. Methods 29 amateur soccer players were randomly assigned to control (n=15) and experimental (n=14) groups with no statistical difference in age or sex (P>0.05). The experimental group used functional rehabilitation training, while the control group was treated with traditional rehabilitation methods. Both groups practiced 30 to 40 minutes of rehabilitation, three times a week, for two months. Mathematical statistics were used to analyze the effects of different injury rehabilitation on the two groups, estimating the ankle joint continuous motion angle by the tibialis anterior muscle electromyogram responses. Results The ankle instability assessment questionnaires were statistically different between the two groups of patients after rehabilitation training (P<0.05). There was a statistical difference in the agility test after the intervention. The ankle capacity score and agility test score were better in the experimental group (P<0.05). Conclusion Functional rehabilitation training can improve ankle performance after a sprain. This training can also help athletes avoid future sprains and is recommended as preventive training. Evidence Level II; Therapeutic Studies - Investigating the result.
Collapse
|
7
|
Desai SS, Dent CS, Hodgens BH, Rizzo MG, Barnhill SW, Allegra PR, Popkin CA, Aiyer AA. Epidemiology and Outcomes of Ankle Injuries in the National Football League. Orthop J Sports Med 2022; 10:23259671221101056. [PMID: 35677018 PMCID: PMC9168861 DOI: 10.1177/23259671221101056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/23/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Traumatic ankle injuries are commonly complicated by persistent symptoms and the development of chronic ankle instability. Purpose: To describe the epidemiology of ankle injuries in the National Football League (NFL) and investigate the effects that ankle injuries have on performance metrics in the years after injury. Study Design: Descriptive epidemiologic study. Methods: Ankle injuries sustained by NFL players during the 2015-2016, 2016-2017, and 2017-2018 seasons were identified using the Pro Football Reference database. Cumulative incidence was calculated, and demographic identifiers were collected for each injury. The return-to-play (RTP) rate was also recorded. For each player who met inclusion for the performance analysis, power rating (PR) was calculated for the preinjury season (Y–1) and 2 postinjury seasons (Y+1 and Y+2) as follows: PR = ( offensive yards/10) + ( total touchdowns × 6) + ( combined tackles) + ( sacks × 2) + ( interceptions × 2). Mean PRs were calculated for each season as well as the percentage change and mean difference in PR between Y–1 and Y+1 (ΔPR1%, ΔPR1) and between Y–1 and Y+2 (ΔPR2%, ΔPR2). Subgroup analyses of PR were performed by player position, injury type, and years of experience. Results: Overall, 668 ankle injuries were identified, with an average cumulative incidence across the 3 seasons of 11.2% and RTP rate of 91%. Of those injuries, 159 met inclusion criteria for the PR analysis. The mean overall PR (96.95 in Y–1) declined 22% in Y+1 to 76.10 (–20.85 [95% CI, –13.82 to –27.89]; P < .001) and 27% in Y+2 to 70.93 (–26.02 [95% CI, –18.04 to –34.00]; P < .001). The mean PR per game played (6.70 in Y–1) decreased 14% in Y+1 to 5.75 (–0.95 [95% CI, –0.56 to –1.34]; P < .001) and 17% in Y+2 to 5.54 (–1.16 [95% CI, –0.63 to –1.62]; P < .001). Conclusion: It was found that ankle injuries hampered the performance of NFL players, even multiple years after the injury occurred, despite a relatively high RTP rate. There was a decrease in total games played after ankle injuries as well as a decreased performance output per game played.
Collapse
Affiliation(s)
- Sohil S. Desai
- Department of Orthopedic Surgery, Columbia University Medical
Center, New York, New York, USA
- Sohil S. Desai, MD, Department of Orthopedic Surgery, Columbia
University Medical Center, 622 W 168th Street, PH 11, New York, NY 10032, USA
() (Twitter: @sdesai_1)
| | - Craig S. Dent
- Nova Southeastern University College of Osteopathic Medicine, Fort
Lauderdale, Florida, USA
| | - Blake H. Hodgens
- University of Miami Miller School of Medicine, Miami, Florida,
USA
| | - Michael G. Rizzo
- Department of Orthopaedic Surgery, University of Miami/Jackson
Memorial Hospital, Miami, Florida, USA
| | - Spencer W. Barnhill
- Department of Orthopaedic Surgery, University of Miami/Jackson
Memorial Hospital, Miami, Florida, USA
| | - Paul R. Allegra
- Department of Orthopaedic Surgery, University of Miami/Jackson
Memorial Hospital, Miami, Florida, USA
| | - Charles A. Popkin
- Department of Orthopedic Surgery, Columbia University Medical
Center, New York, New York, USA
| | - Amiethab A. Aiyer
- Department of Orthopaedic Surgery, Johns Hopkins University School
of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
8
|
Abstract
Since its introduction in 1966, the Bröstrom repair has been the workhorse for the treatment of chronic ankle instability. The procedure has expanded with the advent of arthroscopy, ultrasound, and other techniques. Because chronic ankle sprains/instability pose a barrier to athletes who perform high-level activities for a living, discussions concerning postoperative recovery and return to play criteria are important. Here we present an update on the Bröstrom-Gould procedure from preoperative management to return to play.Level of Evidence: Level V.
Collapse
Affiliation(s)
- Daniel Chiou
- Warren Alpert Medical School, Providence, Rhode Island
| | - Brandon Morris
- Foot and Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Gregory Waryasz
- Foot and Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts
| |
Collapse
|
9
|
Lee S, Song K, Lee SY. Epidemiological study of post-traumatic ankle osteoarthritis after ankle sprain in 195,393 individuals over middle age using the National Health Insurance Database: A retrospective design. J Sci Med Sport 2021; 25:129-133. [PMID: 34565662 DOI: 10.1016/j.jsams.2021.08.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/27/2021] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to determine the risk of ankle OA onset after an incidence of sprain, relative to the risk of onset in healthy population, and to investigate the effect of gender, age, BMI, and exercise on the development of ankle OA after sprain. DESIGN Retrospective cohort study. METHODS Using a sample cohort dataset from 2002 to 2013 provided by the Korean National Health Insurance Sharing Service, we calculated the mean survival time and cumulative incidence rate in sprained and healthy populations using Kaplan-Meier analysis. A Cox proportional hazards model was used to analyze the adjusted hazard ratio (HR) of sprain for the development of OA with 95% confidence intervals (CIs). Adjusted HRs of gender, age, BMI, and exercise (yes/no) were analyzed in the sprained group. RESULTS Among the selected population of 195,393 individuals, 40,876 (20.9%) were diagnosed with an ankle sprain, and 1543 (3.85%) of those individuals developed ankle OA. Of the 154,517 healthy individuals (79.1%), 4062 (2.66%) cases had progressed to OA. The sprained group had 46% (HR, 1.46; 95% CI, 1.38-1.55) greater rate of progression to ankle OA than did healthy individuals. In the sprain group, individuals who were female, obese, and overweight had 40% (HR, 1.40; 95% CI, 1.26-1.55), 43% (HR, 1.43; 95% CI, 1.12-1.82), and 22% (HR, 1.22; 95% CI, 1.10-1.35) higher incidence to develop ankle OA, respectively, compared to those who were male, underweight and normal. CONCLUSIONS This study found that ankle sprain was a significant risk factor for a diagnosis of early OA. Female gender and high BMI increased the incidence of ankle OA after sprain.
Collapse
Affiliation(s)
- Soyoung Lee
- Department of Physical Education, Yonsei University, Republic of Korea
| | - Kyeongtak Song
- Sports Medicine Research Institute, Department of Athletic Training and Clinical Nutrition, University of Kentucky, USA
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Republic of Korea; International Olympic Committee Research Centre KOREA, Yonsei University, Republic of Korea; Institute of Convergence Science, Yonsei University, Republic of Korea.
| |
Collapse
|
10
|
Paget LDA, Aoki H, Kemp S, Lambert M, Readhead C, Stokes KA, Viljoen W, Reurink G, Tol JL, Kerkhoffs GMMJ, Gouttebarge V. Ankle osteoarthritis and its association with severe ankle injuries, ankle surgeries and health-related quality of life in recently retired professional male football and rugby players: a cross-sectional observational study. BMJ Open 2020; 10:e036775. [PMID: 32565473 PMCID: PMC7310999 DOI: 10.1136/bmjopen-2020-036775] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To determine (1) the prevalence of ankle osteoarthritis (OA) among former professional football and rugby players, (2) assess the association between ankle injuries or ankle surgeries with ankle OA, and (3) compare the mental and physical quality of life (QoL) between former professional football and rugby players with and without OA. METHODS We conducted a questionnaire-based observational study with a cross-sectional design. Former professional football and rugby players were recruited by the Football Players Worldwide and the International Rugby Players. Information concerning ankle OA, sustained ankle injuries and ankle surgeries was gathered (medical record or most recent medical professional). Health-related QoL was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) physical and mental health scores. RESULTS Overall, 553 former professional football (n=401) and rugby (n=152) players were enrolled in the study (response rate of 56%). Ankle OA prevalence among former professional football and rugby players was 9.2% and 4.6%, respectively. Football players were more likely to suffer from ankle OA following every ankle injury and/or surgery. Football and rugby players with ankle OA had similar PROMIS physical and mental health scores to the norm for the general population. CONCLUSION Former professional football and rugby players had higher ankle OA prevalence than the general population (3.4%). Football players are more likely to suffer from ankle OA following every ankle injury and/or surgery. No clinically relevant difference was seen for physical or mental health-related QoL among football and rugby players. Preventive measures for ankle injuries are recommended.
Collapse
Affiliation(s)
- Liam D A Paget
- Orthopaedic Surgery, Amsterdam UMC - Locatie AMC, Amsterdam, North Holland, The Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports, AMC/VUMC IOC Research Center (ACHSS), Amsterdam, The Netherlands
| | - Haruhito Aoki
- St Marianna University School of Medicine, Kawasaki, Japan
- Yokohama City Sports Medical Center, Yokohama, Japan
| | | | - Mike Lambert
- Division of Exercise Science and Sports Medicine (ESSM), University of Cape Town, Cape Town, Western Cape, South Africa
| | - Clint Readhead
- Division of Exercise Science and Sports Medicine (ESSM), University of Cape Town, Cape Town, Western Cape, South Africa
- South African Rugby Union (SARU), Cape Town, Western Cape, South Africa
| | - Keith A Stokes
- Rugby Football Union, Twickenham, UK
- Department for Health, University of Bath, Bath, United Kingdom
- Centre for Sport, Exercise and Osteoarthritis Research versus Arthritis, Nottingham, United Kingdom
| | - Wayne Viljoen
- Division of Exercise Science and Sports Medicine (ESSM), University of Cape Town, Cape Town, Western Cape, South Africa
- South African Rugby Union (SARU), Cape Town, Western Cape, South Africa
| | - Gustaaf Reurink
- Orthopaedic Surgery, Amsterdam UMC - Locatie AMC, Amsterdam, North Holland, The Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports, AMC/VUMC IOC Research Center (ACHSS), Amsterdam, The Netherlands
- Sports Medicine, The Sport Physician Group, OLVG, Amsterdam, The Netherlands
| | - Johannes L Tol
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports, AMC/VUMC IOC Research Center (ACHSS), Amsterdam, The Netherlands
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Gino M M J Kerkhoffs
- Orthopaedic Surgery, Amsterdam UMC - Locatie AMC, Amsterdam, North Holland, The Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports, AMC/VUMC IOC Research Center (ACHSS), Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Orthopaedic Surgery, Amsterdam UMC - Locatie AMC, Amsterdam, North Holland, The Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports, AMC/VUMC IOC Research Center (ACHSS), Amsterdam, The Netherlands
- St Marianna University School of Medicine, Kawasaki, Japan
- Football Players Worldwide (FIFPRO), Hoofddorp, The Netherlands
| |
Collapse
|