Knee and Ankle Osteoarthritis in Former Elite Soccer Players: A Systematic Review of the Recent Literature
Kujit MK, Inklaar H, Gouttebarge V, & Frings-Dresen MHW. Journal of Science and Medicine in Sport. 2012 15: 480 - 487.
Take Home Message: Elite soccer athletes may be at an increased risk for knee and ankle osteoarthritis compared with the general population. This group should be identified as high risk and preventative measures should be taken.
While participation in elite-level sports is often viewed as a good thing, there is an established increased risk of short-term injuries (e.g., sprains, strains). This increased injury risk may leave athletes at an increased risk for long-term disability (e.g., osteoarthritis [OA]). The purpose of this systematic review was to investigate the prevalence of knee and ankle OA among former elite-level soccer players. The literature search for the review yielded 4 articles. Former elite-level soccer players had prevalence rates for knee OA between 40 to 80% and 12 to 17% for ankle OA. In comparison, knee OA prevalence rates in the general population were 18 to 25% among adults over 50 years and there is no reportable data for ankle OA prevalence rates (it is likely < 5%, Brown et al. 2006).
Clinically, former elite soccer athletes are at high risk for knee and ankle OA in comparison with the general population. Elite soccer players with more years of experience had a lower knee OA prevalence. The authors hypothesized that it was because they were “more fit.” It would be interesting if any of the studies reported on fitness levels. However, the key question from this systematic review is whether or not the increased risk for OA is a result of sport participation in isolation or injury during participation. If injuries are the primary risk factor then injury prevention programs (e.g., FIFA 11+) may also reduce the risk of long-term disability. Overall, there is glaring evidence that former elite soccer players are having much higher rates of OA. As health care providers, we should be concerned about the athlete’s overall physical health, not just in the immediate short-term. Athletes that incur injuries during their competitive years may be physically hindered once they are older. Knee injuries typically result in OA within 5 to 10 years after the injury. As clinicians, we should be advocates for doing the right thing for the athletes’ long-term health, and not just focus on “getting them back out there.” Furthermore, we may be able to intervene during these early phases immediately post-injury to prevent or delay long-term degenerative changes, ultimately, improving their long-term health outcomes as well.
Does anyone have any experience with any sports population and the development of early OA? Is there anything that we can clinically do for athletes that are already showing signs of OA? Do you think that injury prevention programs are the answer to this problem?
Written by: Nicole Cattano
Reviewed by: Jeffrey Driban
The FIFA11+ Program Is Effective in Preventing Injuries in Elite Male Basketball Players: A Cluster Randomized Controlled TrialKuijt, M., Inklaar, H., Gouttebarge, V., & Frings-Dresen, M. (2012). Knee and ankle osteoarthritis in former elite soccer players: A systematic review of the recent literature Journal of Science and Medicine in Sport, 15 (6), 480-487 DOI: 10.1016/j.jsams.2012.02.008