title: Knee Osteoarthritis Is Associated With Previous Meniscus and Anterior Cruciate Ligament Surgery Among Elite College American Football Athletes.
abstract: BACKGROUND
  Football puts athletes at risk for knee injuries such meniscus and anterior cruciate ligament (ACL) tears, which are associated with the development of osteoarthritis (OA). Previous knee surgery, player position, and body mass index (BMI) may be associated with knee OA.
  
  
  OBJECTIVE
  In elite football players undergoing knee magnetic resonance imaging at the National Football League's Invitational Combine, the prevalence of knee OA is associated with previous knee surgery and BMI.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Level 4.
  
  
  METHODS
  A retrospective review was performed of all participants of the National Football League Combine from 2005 to 2009 who underwent magnetic resonance imaging of the knee because of prior knee injury, surgery, or knee-related symptoms or concerning examination findings. Imaging studies were reviewed for evidence of OA. History of previous knee surgery-including ACL reconstruction, meniscal procedures, and articular cartilage surgery-and position were recorded for each athlete. BMI was calculated based on height and weight.
  
  
  RESULTS
  There was a higher prevalence of OA in knees with a history of previous knee surgery (23% vs 4.0%, P < 0.001). The prevalence of knee OA was 4.0% in those without previous knee surgery, 11% in those with a history of meniscus repair, 24% of those with a history of ACL reconstruction, and 27% of those with a history of partial meniscectomy. Among knees with a previous ACL reconstruction, the rate of OA doubled in tibiofemoral compartments in which meniscal surgery was performed. BMI >30 kg/m2was also associated with a higher risk of OA ( P = 0.007) but player position was not associated with knee OA.
  
  
  CONCLUSIONS
  Previous knee surgery, particularly ACL reconstruction and partial meniscectomy, and elevated BMI are associated with knee OA in elite football players. Future research should investigate ways to minimize the risk of OA after knee surgery in these athletes.
  
  
  CONCLUSIONS
  Treatment of knee injuries in football athletes should consider chondroprotection, including meniscal preservation and cartilage repair, when possible.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Matthew V
authors.initials: MV
authors.lastname: Smith
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Nepple
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Rick W
authors.initials: RW
authors.lastname: Wright
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Matava
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brophy
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000150:complications / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction; D015992:Body Mass Index; D005538:Football / Q000293:injuries*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D000070600:Tibial Meniscus Injuries / Q000150:complications / Q000601:surgery*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: ACL; football; knee osteoarthritis; meniscus