Prevention and Management of Cartilage Injury and Osteoarthritis from Sports
Articular cartilage defects in the knee of young or active individuals remain a problem in Orthopaedic practice. These defects have limited ability to heal and may progress to osteoarthritis (OA). The prevalence of knee OA among athletes is higher than th
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Introduction Osteoarthritis (OA) is the most common musculoskeletal disease and is responsible for decreasing the quality of life among young, active athletes as well as elderly people [1]. The number of people who are affected by OA is increasing due to the increasing age of the population. Obesity, excessive stress to the knee (at work or in sports), previous knee injury, and muscle weakness around knee are known as risk factors [2–5]. In analyzing preventive possibilities, these risk factors are very important. The aim of this review is to evaluate the prevalence of knee OA and the relationship between sports activity and OA. Furthermore to summarize the prevention and treatment of the knee OA and cartilage injury in sports, in order to reduce the increasing impact of knee OA.
Prevalence of Knee OA in Sports The prevalence of knee OA increases with age [1]. Symptomatic knee OA occurs in 10–33 % of those aged 60 years or older [6–8]. This number H. Takeda, MD Department of Sports Orthopedics, Toshiba General Hospital, Tokyo, Japan L. Engebretsen, MD, PhD () Department of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway e-mail: [email protected]
is increasing due to the aging of the population. In professional and recreational athletes, prevalence of knee OA depends on the intensity, frequency, level and sports event (Table 1). The prevalence of knee OA among former soccer players is 19–29 %, long distance runners 14–20 %, and weight-lifters 31 % [9–13]. There are some limitations in these studies. Previous studies which showed the relationship between the sport event and the prevalence of knee OA have various definitions and criteria of OA, the selection of athletes and the method of analysis.
Definition of Knee OA OA is a group of diseases where the homeostasis of articular cartilage chondrocytes , extracellular matrix and subchondral bone is damaged mechanically and biologically [14]. Although OA may be initiated by multiple factors, including genetic, metabolic, and traumatic, they involve all of the tissues of the joint [14]. OA includes morphological, biochemical, molecular, and biomechanical changes of both cells and matrix which leads to softening, fibrillation, and ulceration, loss of articular cartilage, sclerosis and eburnation of subchondral bone, osteophytes, and subchondral cysts [14]. Clinical OA is characterized by joint pain, tenderness, limitation of movement, crepitus, occasional effusion, and variable degrees of inflammation. Most physicians diagnose knee OA not only by the symptoms, but by the
G. Bentley (ed.), European Instructional Lectures, European Instructional Lectures 13, DOI 10.1007/978-3-642-36149-4_18, © EFORT 2013
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Table 1 The prevalence of knee OA in sports Author Roos et al. [9]
Year Subject 1994 Former soccer players
Number 286
Mean age 55
Kujala et al. [10]
1995 Former top-level athlete
117
45–68
Turner et al. [11]
2000 Former professional football players
284
56.1
Drawer and Fuller [12]
2001 Retir
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