The Long Term Impact of Osteoarthritis Following Knee
Surgery in Former Collegiate Athletes
Simon JE,
Grooms DR, and Docherty CL. J Sports Rehab.
2017. [Epub Ahead of Print].
Take Home Message: Many former college athletes with a
history of knee surgery, especially for meniscal pathology, reported a
diagnosis of osteoarthritis. Those with a history of surgery and diagnosis of
osteoarthritis reported poorer long-term outcomes than their peers.
Joint injury – and
subsequent surgery – have a major impact on an athlete’s quality of life and
increases the risk for an early onset of osteoarthritis. Unfortunately, we know
very little about the state of our patients’ quality of life 15 to 25 years
after surgery. Therefore, Simon and colleagues completed a cross-sectional
study to identify the long-term consequences of knee surgery in a cohort of
former collegiate athletes. A total of 100 (60 males, 40 females) former
Division 1 athletes between 40 and 65 years of age completed questionnaires to
collect demographics, past injury history (including any previous diagnosis of
osteoarthritis), knee-related symptoms (KOOS), and overall quality of
life (SF-36v2). Overall, 77% of
athletes with a history of knee surgery reported being diagnosed with knee
osteoarthritis. A significant majority of participants who developed knee
osteoarthritis after having a surgery, reported combination injuries
(ligamentous and meniscal; 55%) or meniscal injuries (27%). Conversely,
participants who reported a previous knee surgery but no diagnosis of
osteoarthritis reported that their injuries were primarily ligamentous only. On
average, the individuals with a history of knee surgery and diagnosis of knee
osteoarthritis had worse physical quality of life worse and knee-related pain,
symptoms, quality of life, and function. The adults with a history of knee
surgery but not osteoarthritis had similar quality of life and knee-related
outcomes as adults with no history of knee surgery.
Overall, many people
with a history of knee surgery, especially for meniscal pathology, reported a
diagnosis of osteoarthritis. This subset of adults with a history of knee
surgery and diagnosis of osteoarthritis also typically reported poorer
long-term outcomes (e.g., lower quality of life, poorer physical function). It
is important to consider that these adults typically had surgery 19 to 40 years
ago when partial or total meniscectomies were more commonly performed than
today. Previous literature has demonstrated that preserving a meniscus is likely
key to protecting the long-term health of a joint. Thus, when meniscal injuries
are diagnosed clinicians should encourage their patients to seek interventions
to restore/preserve the protective properties of the meniscus.  Given the timing of this assessment, we can’t
rule out that some former athletes incorrectly reported their history of knee
surgery or diagnosis of osteoarthritis. This study offers compelling evidence
that we need to begin monitoring our athletes over time to see how quality of
life changes as they age. In the meantime, this study offers further evidence
that we need to encourage the use of injury prevention programs to help reduce
the number of athletes who need knee surgery. It remains remarkable that injury
prevention programs, which can dramatically reduce the risk of injury and
surgery and probably the long-term consequences of these events remains
underutilized in sports.  
for Discussion
: Do you talk to patients after knee surgery about how to preserve their
quality of life and physical function?
Written by: Kyle Harris
Reviewed by: Jeffrey
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