Outcomes associated with early post-traumatic osteoarthritis and other negative health consequences 3–10 years following knee joint injury in youth sport

• Published in: Osteoarthritis and cartilage Vol. 23; no. 7; pp. 1122 - 1129
• Main Authors: Whittaker, J.L, Woodhouse, L.J, Nettel-Aguirre, A, Emery, C.A
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-07-2015
• Subjects: Activities of Daily Living; Adolescent; Adult; Anthropometry - methods; Body Mass Index; Case-Control Studies; Female; Follow-Up Studies; Humans; Knee Injuries - complications; Knee Injuries - physiopathology; Knee Injuries - rehabilitation; Knee injury; Male; Muscle Strength - physiology; Obesity; Obesity - etiology; Osteoarthritis; Osteoarthritis, Knee - etiology; Prognosis; Rheumatology; Young Adult; Youth Sports - injuries; Obesity; Knee injury; Osteoarthritis; Adolescent
• ISSN: 1063-4584; 1522-9653
• DOI: 10.1016/j.joca.2015.02.021

Summary 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. Design 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 (VO2 max) 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 VO2 max, 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.