Knee and Ankle Osteoarthritis in Former Elite Soccer
Players: A Systematic Review of the Recent Literature

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.

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).

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

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?

by: Nicole Cattano
by: Jeffrey Driban

Related Posts:

Kuijt, 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