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Former professional soccer players found more likely to have knee OA vs general population
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WASHINGTON — Compared with the United Kingdom’s general population, former professional soccer players had a prevalence of knee pain, radiographic knee osteoarthritis and total knee replacement that was two- to three-times higher and occurred between 5 years and 20 years earlier, according to findings presented at the American College of Rheumatology Annual Meeting.
“Football, or soccer, is the world’s most popular team sport and it is a sport that is characterized by high intensity match play and training over a particularly prolonged period of time,” Gwen Fernandes, MD, clinical researcher in the Division of Rheumatology at the University of Nottingham School of Medicine, said during her presentation. “The average career of a professional footballer in the United Kingdom is approximately 13 years, so over this time, you have significant risk of injury.”
Fernandes and colleagues recruited 1,207 former soccer players and 4,085 participants from the general population as controls. They examined radiographic knee osteoarthritis (RKOA) in a subset of 470 of the soccer players and 491 of the controls using the Nottingham Line Drawing Atlas (NLDA) scores and Kellgren Lawrence grading with a cut-off score of at least 3. The average age was 59 years for the soccer players and 62.8 years for the controls. In the univariate analysis, the researchers adjusted for age, BMI, knee injury, high-risk occupation, 2D4D digit ratio, self-reported constitutional knee alignment and nodal OA.
After adjusting for these risk factors, the researchers found the soccer players were 1.69-times more likely to develop RKOA compared with the controls. Across all age groups, soccer players reported more knee pain and knee pain close to 20 years earlier compared with controls. They also reported RKOA 20 years earlier and total knee replacement (TKR) 5 years earlier on average. In addition, soccer players were 2.79-times more likely to have a TKR; 2.62-times more likely to have a physician diagnosis of OA; and 1.78-times more likely to have radiographic chondrocalcinosis.
Employers should consider this risk in determining whether KOA should be compensated, the researchers wrote.
“If a professional player went on to become a builder, a mechanic or a carpet fitter, they still have this elevated risk of developing these certain knee OA outcomes,” Fernandes said. – by Will Offit
Reference:
Fernandes G, et al. Abstract #2029. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.
Disclosure: The researchers report no relevant financial disclosures.
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Andy Williams, MB BS, FRCS, FRCS(Orth), FFSEM(UK)
The authors have done an amazing job recruiting ex-players and controls. The ex-soccer players had much more knee pain, radiographic osteoarthritis (OA), which occurred 20 years prematurely, and knee replacements that occurred on average 5 years earlier than controls. They also had more knee malalignment, history of knee injury and, interestingly, nodal OA, which all increase OA risk.
The point is well made and it is a quality addition to the little literature on the subject. Since the average age of ex-players was 59 years, most would have been playing in the 1980s. Since then, considerable improvement in sports medicine has occurred. As a result, the outlook now may not be so bleak. Nevertheless, while in many ways good for humanity, sport is also a risky business.
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