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Prevalence of knee pain, radiographic osteoarthritis and arthroplasty in retired professional footballers compared to men in the general population: a cross-sectional study

Fernandes, Gwen Sascha; Parekh, Sanjay M.; Moses, Jonathan; Fuller, Colin; Scammell, Brigitte E.; Batt, Mark E.; Zhang, Weiya; Doherty, Michael

Authors

Gwen Sascha Fernandes

Sanjay M. Parekh sanjaymparekh@outlook.com

Jonathan Moses

Colin Fuller

Brigitte E. Scammell

Mark E. Batt

Weiya Zhang

Michael Doherty



Abstract

Objectives: To determine the prevalence of knee pain, radiographic knee osteoarthritis (RKOA), total knee replacement (TKR) and associated risk factors in male ex-professional footballers compared to men in the general population (comparison group).
Methods: 1207 male ex-footballers and 4085 men in the general population in the UK were assessed by postal questionnaire. Current knee pain was defined as pain in or around the knees on most days of the previous month. Presence and severity of RKOA were assessed on standardised radiographs using the Nottingham Line Drawing Atlas (NLDA) in a sub-sample of 470 ex-footballers and 491 men in the comparison group. The adjusted risk ratio (aRR) and risk difference (aRD) with 95% confidence interval (CI) in ex-footballers compared to the general population were calculated using the marginal model in Stata.
Results: Ex-footballers were more likely than the comparison group to have current knee pain [aRR 1.91, 95%CI 1.77-2.06], RKOA [aRR 2.21, 95%CI 1.92-2.54] and TKR (aRR 3.61, 95%CI 2.90–4.50). Ex-footballers were also more likely to present with chondrocalcinosis [aRR 3.41, 95%CI 2.44-4.77]. Prevalence of knee pain and RKOA were higher in ex-footballers at all ages. However, even after adjustment for significant knee injury and other risk factors, there was more than a doubling of risk of these outcomes in footballers.
Conclusions: The prevalence of all knee osteoarthritis outcomes (knee pain, RKOA and TKR) were 2-3 times higher in male ex-footballers compared to men in the general population group. Knee injury is the main attributable risk factor. Even after adjustment for recognised risk factors, knee osteoarthritis appear to be an occupational hazard of professional football.

Journal Article Type Article
Publication Date Nov 3, 2017
Journal British Journal of Sports Medicine
Print ISSN 0306-3674
Electronic ISSN 1473-0480
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
APA6 Citation Fernandes, G. S., Parekh, S. M., Moses, J., Fuller, C., Scammell, B. E., Batt, M. E., …Doherty, M. (2017). Prevalence of knee pain, radiographic osteoarthritis and arthroplasty in retired professional footballers compared to men in the general population: a cross-sectional study. British Journal of Sports Medicine, doi:10.1136/bjsports-2017-097503. ISSN 0306-3674
DOI https://doi.org/10.1136/bjsports-2017-097503
Keywords Knee osteoarthritis; professional football; epidemiology; knee radiographs; knee pain; risk factors; chondrocalcinosis
Publisher URL https://bjsm.bmj.com/content/early/2017/10/25/bjsports-2017-097503
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
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AM - Accepted Manuscript






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