title: Is Participation in Certain Sports Associated With Knee Osteoarthritis? A Systematic Review.
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.
  
  
  METHODS
  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).
  
  
  METHODS
  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.
  
  
  METHODS
  One investigator extracted data (eg, group descriptions, knee OA prevalence, source of nonexposed controls).
  
  
  RESULTS
  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.
authors.affiliation: Division of Rheumatology, Tufts Medical Center, Boston, MA.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Driban
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Hootman
authors.affiliation: Temple University, Philadelphia, PA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Sitler
authors.affiliation: Department of Health, Physical Education and Nursing, Bucks County Community College, Newton, PA.
authors.forename: Kyle P
authors.initials: KP
authors.lastname: Harris
authors.affiliation: West Chester University of Pennsylvania.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Cattano
mesh_terms: D001265:Athletic Injuries / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D005538:Football / Q000293:injuries; D006801:Humans; D020370:Osteoarthritis, Knee / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D012420:Running / Q000293:injuries; D012916:Soccer / Q000293:injuries; D014891:Weight Lifting / Q000293:injuries; D014952:Wrestling / Q000293:injuries
keywords: athletic injuries; epidemiology; injury; injury prevention