Sports Medicine Research: In the Lab & In the Field: Potentially Modifiable Osteoarthritis Risk Factors (Sports Med Res)
Wednesday, July 24, 2013

Potentially Modifiable Osteoarthritis Risk Factors

Are Joint Injury, Sport Activity, Physical Activity, Obesity, or Occupational Activities Predictors for Osteoarthritis?  A Systematic Review.

Richmond SA, Fukuchi RK, Ezzat A, Scheider K, Scheider G, & Emery CA. Journal of Orthopaedic and Sports Physical Therapy.  2013, Epub ahead of print.  doi: 10.2519/jospt.2013.4796

Take Home Message: Osteoarthritis prevention programs could focus on certain risk factors, such as joint injury, obesity, and occupational activities.

Osteoarthritis (OA), a degenerative joint disease, affects millions of adults worldwide.  There are many potential risk factors for OA, including several of interest in sports medicine: obesity, repetitive tasks (physical or occupational activity), and joint injury.  It is important to understand what modifiable risk factors may exist so that we can develop OA prevention and management strategies.  The purpose of this systematic review was to identify if joint injury, sport activity, physical activity, obesity, or occupational activity are modifiable risk factors for OA.  The authors included 43 studies. The studies varied in research design; focused on ankle, knee, or hip OA; ranged from 16 to 8000 participants; and followed participants from 30 months to > 40 years.  Most studies examined one potential risk factor: joint injury (16 studies), obesity (13 studies), sport activity (12 studies), physical activity (5 studies), or occupational activity (9 studies).  The authors identified previous joint injury; obesity; and occupational activities that involved heavy lifting, squatting/kneeling, climbing stairs, or high physical demands as clear risk factors for hip and knee OA. The authors reported that they had insufficient evidence to define the risk associated with different levels of physical activity or sport-specific risk, particularly among individuals without a history of injury. 

This systematic review confirmed that individuals who suffered a joint injury, were overweight, or worked in a physically demanding occupation are at an increased risk for hip or knee OA.  Clinically, this helps us to identify individuals who may be at-risk for OA long before they show signs of the disease.  As sports medicine clinicians, we could directly impact the long-term health of our athletes.  For example, if we deploy injury prevention programs we may reduce the risk of injuries in the short-term, and therefore decrease the risk of OA in the long-term.  We can also counsel heavier athletes to pursue healthy lifestyles and promote healthy weight loss.  Lastly, sports medicine clinicians are increasingly working with individuals in the industrial setting where employees are exposed to physically demanding work and may be at an elevated risk for joint trauma. As clinicians, we may be able to modify activities, instruct workers on appropriate techniques, or implement injury prevention programs in this setting.  This systematic review is informative, but it also demonstrates the scarcity of information that we have surrounding OA risk factors. As more information becomes available we will be better informed to not only prevent injuries among physically-active individuals but also prevent their long-term health issues.   

Questions for Discussion: Do you think that we have enough information to potentially develop OA prevention strategies?  What are some strategies that you may suggest in these at-risk populations?
 
Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

Related Posts:
Richmond SA, Fukuchi RK, Ezzat A, Schneider K, Schneider G, & Emery CA (2013). Are Joint Injury, Sport Activity, Physical Activity, Obesity, or Occupational Activities Predictors for Osteoarthritis? A Systematic Review. The Journal of Orthopaedic and Sports Physical Therapy PMID: 23756344

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