Every second retired elite female football player has MRI evidence of knee osteoarthritis before age 50 years: a cross-sectional study of clinical and MRI outcomes

Abstract

Purpose To assess knee health in retired female football players, using magnetic resonance imaging (MRI) and self‐report. The focus of analysis were degenerative changes of the tibiofemoral joint, and their relationship to osteoarthritis symptoms and previous knee injury. Methods Forty‐nine retired elite, female football players (98 knees) aged 37 years on average participated. Tibiofemoral cartilage and meniscus status of both knees were evaluated using MRI and graded according to modified Outerbridge and Stoller classifications, respectively. Symptoms were assessed through a standardised questionnaire (Knee Osteoarthritis Outcome Score: KOOS). Knee injury history was recorded via a semi‐structured interview. To investigate how injury variables relate to outcomes, binary logistic regression models were used and reported with odds ratios (OR). Results Fifty‐one per cent of players (n = 25) fulfilled the MRI criterion for knee osteoarthritis, 69.4% (n = 34) had substantial meniscal loss and 59.6% (n = 28) reported substantial clinical symptoms. Chondral‐ and meniscal loss were associated with significantly lower scores on three of five KOOS subscales (p < .05). Both chondral and meniscal loss were significantly predicted by previous traumatic knee injury (OR = 4.6, OR = 2.6), the injury affecting the non‐striking leg (OR = 8.6, OR = 10.6) and type of injury; participants with combined ACL/meniscus injuries had the highest risk for substantial chondral and meniscal loss (OR = 14.8, OR = 9.5). Chondral loss was significantly predicted by isolated meniscus injury treated with partial meniscectomy (OR = 5.4), but not by isolated reconstructed ACL injury. Clinical symptoms were only significantly predicted by previous traumatic knee injury (OR = 5.1). Conclusions Serious degenerative changes were found in a high number of retired female football players’ knees 10 years after their career. Meniscal integrity is key for knee osteoarthritis outcomes in young adults, and thus, its preservation should be a priority.

Delayed ankle muscle reaction time in female amateur footballers after the first 15 min of a simulated prolonged football protocol

“…Historically, injury incidence has been high in women's football [2] and remains so today [3]. It is expected that female footballrelated injuries and longer-term wellbeing will become a significant topic in sports medicine as evidenced by several recent publications [4][5][6]. A recent systematic review also suggested that recreational football practice is medicineit is beneficial for cardiovascular and bone health, body composition, type 2 diabetes, and prostate cancer [7].…”

Occupational risk factors for meniscal lesions: a systematic review and meta-analysis

“…Of the 22 included records, 16 studies had a cross-sectional design, four were case-control studies [ 24 – 26 , 51 ] and two cohort studies [ 35 , 36 ]. Two studies were from the United States [ 40 , 50 ] and one from South Korea [ 53 ] but the majority was conducted in Europe: Germany ( n = 6, Federal Republic of Germany ( n = 4) [ 38 , 45 , 46 , 51 ], German Democratic Republic ( n = 2) [ 43 , 44 ]), Denmark ( n = 3) [ 8 , 17 , 36 ], United Kingdom ( n = 3) [ 24 – 26 ], Finland ( n = 2) [ 27 , 35 ], Czech Republic ( n = 1) [ 42 ], Netherlands ( n = 1) [ 39 ], Russia ( n = 1) [ 37 ], Slovenia ( n = 1) [ 41 ] and Sweden ( n = 1) [ 47 ]. The year of study publication ranged from 1962 to 2020.…”

“…Most studies ( n = 14) involved only male participants, four studies [ 24 , 35 , 52 , 53 ] recruited both sexes and one study [ 46 ] included only females. Three studies did not provide any information about the sex of participants, but we presumed that they were predominantly male, as in two studies which investigated professional football players there was no professional women’s league at time of recruitment [ 39 , 41 ], or due to the nature of the described occupation (manual welders in ship-building) [ 43 ].…”

“…Three studies did not provide any information about the sex of participants, but we presumed that they were predominantly male, as in two studies which investigated professional football players there was no professional women’s league at time of recruitment [ 39 , 41 ], or due to the nature of the described occupation (manual welders in ship-building) [ 43 ]. The studies included professional football players ( n = 6) [ 37 – 39 , 41 , 46 , 47 ], professional basketball players ( n = 2) [ 40 , 50 ], floor layers ( n = 3) [ 8 , 17 , 27 ], miners ( n = 2) [ 26 , 42 ] and one each focused on baggage handlers [ 36 ], pipefitters [ 44 ], shunters [ 45 ], manual welders [ 43 ], and farmers [ 53 ]. Four studies [ 24 , 25 , 35 , 51 ] included workers from different industries or did not target a specific occupational group but reported on knee-straining occupational activities.…”

Orthopedic Injuries from Video Games: A Literature Review and Implications for the Future

“…One article suggests that physical load from sports may put women at risk for development of severe hip osteoarthrosis [16]. Another study found over half of retired elite female soccer players have osteoarthritis and meniscus tears [17]. There is also high prevalence of hip and knee osteoarthritis arthroplasty among former elite male athletes [18].…”