Osteoarthrosis in runners with knee pain.

McDermott, Mike; Freyne, P.

doi:10.1136/bjsm.17.2.84

Cited by 75 publications

(28 citation statements)

References 9 publications

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“…Four of these six patients had a history of a major knee injury, which, presumably, had increased the vulnerability of their joint. 20 Of the 14 patients without radiographic OA, only 3 had had a major knee injury previously.…”

Section: Loading Factorsmentioning

confidence: 98%

Risk Factors for Osteoarthritis

Felson

2004

Clinical Orthopaedics &Amp; Related Research

170

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Joint damage occurs when structures protecting the joint fail. Because osteoarthritis consists of end-stage joint damage, I propose that risk factors for disease can be best understood as either impairments of joint protectors, increasing joint vulnerability, or as factors that excessively load the joint, leading to injury. I review current knowledge using this paradigm, separating factors into those increasing joint vulnerability (malalignment, muscle weakness, genetic and ethnic predispositions, aging) and those that cause excessive loading (obesity; certain physical activities). Osteoarthritis and cartilage loss can occur without pain. This review focuses separately on factors associated with pain in those with osteoarthritis. To identify sources of pain in osteoarthritis, recent studies have compared magnetic resonance imaging findings of people with osteoarthritis with and without pain, focusing on structures known to have nociceptive innervations. Those with pain are more likely to have effusions, bone marrow lesions, synovial hypertrophy, and tendinitis and bursitis around the joint. This review creates a new paradigm for understanding risk factors for osteoarthritis, using joint vulnerability and loading as a framework and focuses separately on the emerging investigative area of sources of pain.

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Section: Loading Factorsmentioning

confidence: 98%

Risk Factors for Osteoarthritis

Felson

2004

Clinical Orthopaedics &Amp; Related Research

170

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“…However, Marti et al (1989) found radio- logically more degenerative changes in the hip joints of former national team long-distance runners than in bobsleigh competitors and the reference population [53]. Also, runners who had sustained injuries, or who had anatomical abnormalities but continued running training, showed accelerated development of OA in affected joints [54]. Different types of exercise or sports activities, which repetitively expose joints to high levels of impact or torsional loading, are associated with increased prevalence of OA [55][56][57][58][59][60].…”

Section: Increased Joint Loading and Weight-bearingmentioning

confidence: 99%

Regular joint loading in youth assists in the establishment and strengthening of the collagen network of articular cartilage and contributes to the prevention of osteoarthrosis later in life: a hypothesis

et al. 2000

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importance of regular joint loading in young age for the development of a well-organized and strong articular cartilage collagen network, which contributes to the prevention of OA later in life. The load-bearing properties of articular cartilage as well as the main features of the metabolism and turnover of proteoglycans (PGs) and collagen are briefly reviewed, especially in relation to joint loading. Prevention of OAThe knowledge of the pathogenesis of OA and its risk factors is today supplemented at an increasing pace, which makes the prospects for prevention of the disease more and more realistic [2][3][4][5][6][7][8]. OA is a disease with a multifactorial etiology. It affects not only the articular cartilage but the whole synovial joint organ. This implies that in addition to articular cartilage, the properties of the subchondral bone and ligaments, the weight-bearing conditions including the biomechanical alignment of the joint, the weakness of the shockabsorbing and weight-bearing muscles, and the integrity and proper function of the neuromuscular system must be taken into regard [9]. Even though the OA process in the joint structures is accomplished by biochemical signals, i.e., cytokines, growth factors, proteins and enzymes, the disease appears to be primarily driven by the local mechanical factors in the joint. Thus, the mechanical etiology of OA deserves ongoing close scrutiny [9].The primary prevention of OA emphasizes hindering the disease from affecting healthy persons [2,5]. Large epidemiological studies on OA have pointed out several risk factors that can be influenced by adjusting our lifestyles. For example, obese persons are instructed to reduce body weight and to carry out exercises to strengthen their lower limb muscles to reduce stress at

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“…30,63,98,102 A study of 20 middle-aged runners with knee pain for at least 3 months suggested that joint abnormalities may be related to the development of degenerative disease in association with running. 73 In this investigation, 20 individuals with a mean age of 39 years who had run an average of 62 miles a week for 20 years were examined clinically and radiographically. Six of the 20 had evidence of degenerative joint disease.…”

Section: Factors That Increase the Risk Of Joint Injury And Degenerationmentioning

confidence: 99%

“…102 This latter observation supports the concept that age increases the vulnerability of articular cartilage to the development of degenerative changes, possibly because of loss of the ability of chondrocytes to maintain and restore the articular surface. [66][67][68][69][70][71][72][73][74][75][76][77] The age-related decline in chondrocyte function, a phenomena referred to as cell senescence, 66,68,70 may be accelerated by joint injuries and residual joint instability following injury.…”

Section: Factors That Increase the Risk Of Joint Injury And Degenerationmentioning

confidence: 99%