Outcomes associated with early post-traumatic osteoarthritis and other negative health consequences 3-10 years following knee joint injury in youth sport.
OBJECTIVE
Post-traumatic osteoarthritis (PTOA) commonly affects the knee joint. Although the risk of PTOA substantially increases post-joint injury, there is little research examining PTOA outcomes early in the period between joint injury and disease onset. Improved understanding of this interval would inform secondary prevention strategies aimed at preventing and/or delaying PTOA progression. This study examines the association between sport-related knee injury and outcomes related to development of PTOA, 3-10 years post-injury.


METHODS
This preliminary analysis of the first year of a historical cohort study includes 100 (15-26 years) individuals. Fifty with a sport-related intra-articular knee injury sustained 3-10 years previously and 50 uninjured age, sex and sport matched controls. The primary outcome was the 'Symptoms' sub-scale of the Knee Osteoarthritis and Injury Outcome Score (KOOS). Secondary outcomes included; the remaining KOOS subscales, body mass index (BMI), hip abductor/adductor and knee extensor/flexor strength, estimated aerobic capacity (VO2max) and performance scores on three dynamic balance tests. Descriptive statistics (mean within-pair difference; 95% Confidence interval (CI) and conditional odds ratio (OR, 95% CI; BMI) were used to compare study groups.


RESULTS
Injured participants demonstrated poorer KOOS outcomes [symptoms -9.4 (-13.6, -5.2), pain -4.0 (-6.8, -1.2), quality-of-life -8.0 (-11.0, -5.1), daily living -3.0 (-5.0, -1.1) and sport/recreation -6.9 (-9.9, -3.8)], were 3.75 times (95% CI 1.24, 11.3) more likely to be overweight/obese and had lower triple single leg hop scores compared to controls. No significant group differences existed for remaining balance scores, estimated VO2max, hip or knee strength ratios or side-to-side difference in hip abductor/adductor or quadricep/hamstring strength.


CONCLUSIONS
This study provides preliminary evidence that youth/young adults following sport-related knee injury report more symptoms and poorer function, and are at greater risk of being overweight/obese 3-10 years post-injury compared to matched uninjured controls.
Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada; The Alberta Children's Hospital Research Institute for Child and Maternal Health, Cumming School of Medicine, University of Calgary, Calgary, Canada. Electronic address: j.whittaker@ucalgary.ca.
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Whittaker
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada; Alberta Health Services, Bone and Joint Health Strategic Clinical Network, Alberta, Canada. Electronic address: linda.woodhouse@ualberta.ca.
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Woodhouse
The Alberta Children's Hospital Research Institute for Child and Maternal Health, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada. Electronic address: anettela@ucalgary.ca.
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Nettel-Aguirre
Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada; The Alberta Children's Hospital Research Institute for Child and Maternal Health, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada. Electronic address: caemery@ucalgary.ca.
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D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000886:Anthropometry / Q000379:methods; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D009765:Obesity / Q000209:etiology; D020370:Osteoarthritis, Knee / Q000209:etiology*; D011379:Prognosis; D055815:Young Adult; D000067009:Youth Sports / Q000293:injuries*
Adolescent; Knee injury; Obesity; Osteoarthritis