Is Participation in Certain Sports Associated With Knee Osteoarthritis? A Systematic Review

Overview

Journal J Athl Train

Specialty Orthopedics

Date 2015 Jan 10

PMID 25574790

Citations 62

Authors

Jeffrey B Driban

Jennifer M Hootman

Michael R Sitler

Kyle P Harris

Nicole M Cattano

Affiliations

Soon will be listed here.

Abstract

Objective: Information regarding the relative risks of developing knee osteoarthritis (OA) as a result of sport participation is critical for shaping public health messages and for informing knee-OA prevention strategies. The purpose of this systematic review was to investigate the association between participation in specific sports and knee OA.

Data Sources: We completed a systematic literature search in September 2012 using 6 bibliographic databases (PubMed; Ovid MEDLINE; Journals@Ovid; American College of Physicians Journal Club; Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Review, Database of Abstracts of Reviews of Effects; and Ovid HealthStar), manual searches (4 journals), and reference lists (56 articles).

Study Selection: Studies were included if they met the following 4 criteria: (1) an aim was to investigate an association between sport participation and knee OA; (2) the outcome measure was radiographic knee OA, clinical knee OA, total knee replacement, self-reported diagnosis of knee OA, or placement on a waiting list for a total knee replacement; (3) the study design was case control or cohort; and (4) the study was written in English. Articles were excluded if the study population had an underlying condition other than knee OA.

Data Extraction: One investigator extracted data (eg, group descriptions, knee OA prevalence, source of nonexposed controls).

Data Synthesis: The overall knee-OA prevalence in sport participants (n = 3759) was 7.7%, compared with 7.3% among nonexposed controls (referent group n = 4730, odds ratio [OR] = 1.1). Specific sports with a significantly higher prevalence of knee OA were soccer (OR = 3.5), elite-level long-distance running (OR = 3.3), competitive weight lifting (OR = 6.9), and wrestling (OR = 3.8). Elite-sport (soccer or orienteering) and nonelite-sport (soccer or American football) participants without a history of knee injury had a greater prevalence of knee OA than nonexposed participants.

Conclusions: Participants in soccer (elite and nonelite), elite-level long-distance running, competitive weight lifting, and wrestling had an increased prevalence of knee OA and should be targeted for risk-reduction strategies.

Citing Articles

The Expression Level of SOX Family Transcription Factors' mRNA as a Diagnostic Marker for Osteoarthritis.

Baran K, Brzezianska-Lasota E, Kryczka J, Boncela J, Czechowska A, Kopacz K J Clin Med. 2025; 14(4).

PMID: 40004707 PMC: 11856735. DOI: 10.3390/jcm14041176.

A New Way to Treat Central Nervous System Dysfunction Caused by Musculoskeletal Injuries Using Transcranial Direct Current Stimulation: A Narrative Review.

Perrey S Brain Sci. 2025; 15(2).

PMID: 40002434 PMC: 11853165. DOI: 10.3390/brainsci15020101.

Optimal exercise modalities and doses for therapeutic management of osteoarthritis of the knee.

Whitfield M, Tomlinson O Front Aging. 2025; 6:1458983.

PMID: 39967997 PMC: 11832510. DOI: 10.3389/fragi.2025.1458983.

Incidence rate of total knee arthroplasties in eleven European countries: Do they reach a plateau?.

Le Stum M, Le Goff-Pronost M, Stindel E, Dardenne G PLoS One. 2025; 20(1):e0312701.

PMID: 39774372 PMC: 11706380. DOI: 10.1371/journal.pone.0312701.

High Prevalence of Varus Knee Malalignment in Adolescent Football Players-Clinical Lower Leg Axis Measurements of Male Junior Football Players Aged 7 to 18 Years.

Memmel C, Sporrer D, Szymski D, Weber J, Hanke A, Denzinger M Children (Basel). 2024; 11(8).

PMID: 39201888 PMC: 11352970. DOI: 10.3390/children11080953.

References

Moretz 3rd J, Harlan S, Goodrich J, Walters R . Long-term followup of knee injuries in high school football players. Am J Sports Med. 1984; 12(4):298-300. DOI: 10.1177/036354658401200410. View

Sandmark H, Vingard E . Sports and risk for severe osteoarthrosis of the knee. Scand J Med Sci Sports. 1999; 9(5):279-84. DOI: 10.1111/j.1600-0838.1999.tb00246.x. View

Thadhani R, Tonelli M . Cohort studies: marching forward. Clin J Am Soc Nephrol. 2007; 1(5):1117-23. DOI: 10.2215/CJN.00080106. View

Murphy L, Schwartz T, Helmick C, Renner J, Tudor G, Koch G . Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008; 59(9):1207-13. PMC: 4516049. DOI: 10.1002/art.24021. View

Bijlsma J, Knahr K . Strategies for the prevention and management of osteoarthritis of the hip and knee. Best Pract Res Clin Rheumatol. 2007; 21(1):59-76. DOI: 10.1016/j.berh.2006.08.013. View

Cooper C, Snow S, McAlindon T, Kellingray S, Stuart B, Coggon D . Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000; 43(5):995-1000. DOI: 10.1002/1529-0131(200005)43:5<995::AID-ANR6>3.0.CO;2-1. View

Rochon P, Gurwitz J, Sykora K, Mamdani M, Streiner D, Garfinkel S . Reader's guide to critical appraisal of cohort studies: 1. Role and design. BMJ. 2005; 330(7496):895-7. PMC: 556167. DOI: 10.1136/bmj.330.7496.895. View

Thelin N, Holmberg S, Thelin A . Knee injuries account for the sports-related increased risk of knee osteoarthritis. Scand J Med Sci Sports. 2006; 16(5):329-33. DOI: 10.1111/j.1600-0838.2005.00497.x. View

Felson D, Lawrence R, Dieppe P, Hirsch R, Helmick C, Jordan J . Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med. 2000; 133(8):635-46. DOI: 10.7326/0003-4819-133-8-200010170-00016. View

10.

Kujala U, Sarna S, Kaprio J, Koskenvuo M, Karjalainen J . Heart attacks and lower-limb function in master endurance athletes. Med Sci Sports Exerc. 1999; 31(7):1041-6. DOI: 10.1097/00005768-199907000-00018. View

11.

Cheng Y, Macera C, Davis D, Ainsworth B, Troped P, Blair S . Physical activity and self-reported, physician-diagnosed osteoarthritis: is physical activity a risk factor?. J Clin Epidemiol. 2000; 53(3):315-22. DOI: 10.1016/s0895-4356(99)00168-7. View

12.

Felson D . Risk factors for osteoarthritis: understanding joint vulnerability. Clin Orthop Relat Res. 2004; (427 Suppl):S16-21. DOI: 10.1097/01.blo.0000144971.12731.a2. View

13.

Roos H, Lindberg H, Gardsell P, Lohmander L, Wingstrand H . The prevalence of gonarthrosis and its relation to meniscectomy in former soccer players. Am J Sports Med. 1994; 22(2):219-22. DOI: 10.1177/036354659402200211. View

14.

Tveit M, Rosengren B, Nilsson J, Karlsson M . Former male elite athletes have a higher prevalence of osteoarthritis and arthroplasty in the hip and knee than expected. Am J Sports Med. 2011; 40(3):527-33. DOI: 10.1177/0363546511429278. View

15.

Felson D, Zhang Y . An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum. 1998; 41(8):1343-55. DOI: 10.1002/1529-0131(199808)41:8<1343::AID-ART3>3.0.CO;2-9. View

16.

Lawrence R, Felson D, Helmick C, Arnold L, Choi H, Deyo R . Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008; 58(1):26-35. PMC: 3266664. DOI: 10.1002/art.23176. View

17.

Issa S, Sharma L . Epidemiology of osteoarthritis: an update. Curr Rheumatol Rep. 2006; 8(1):7-15. DOI: 10.1007/s11926-006-0019-1. View

18.

Klussmann A, Gebhardt H, Nubling M, Liebers F, Quiros Perea E, Cordier W . Individual and occupational risk factors for knee osteoarthritis: results of a case-control study in Germany. Arthritis Res Ther. 2010; 12(3):R88. PMC: 2911872. DOI: 10.1186/ar3015. View

19.

Lau E, Cooper C, Lam D, Chan V, Tsang K, Sham A . Factors associated with osteoarthritis of the hip and knee in Hong Kong Chinese: obesity, joint injury, and occupational activities. Am J Epidemiol. 2000; 152(9):855-62. DOI: 10.1093/aje/152.9.855. View

20.

Manninen P, Riihimaki H, Heliovaara M, Suomalainen O . Physical exercise and risk of severe knee osteoarthritis requiring arthroplasty. Rheumatology (Oxford). 2001; 40(4):432-7. DOI: 10.1093/rheumatology/40.4.432. View