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?
by: Nicole Cattano
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