|
 Researchers followed almost 150,000 adults ages 25 to 34, including
about 5,200 with a history of knee injuries, for almost two decades.
Compared to people who never had knee injuries, those who did were
nearly six times as likely to develop knee osteoarthritis during the
first 11 years of follow-up, with more than triple the risk over the
next eight years.
"Injuries that occur inside the knee joint, for example in the
meniscus or cruciate ligament, may alter the biomechanical loading
patterns in the knee," said study leader Barbara Snoeker, of Lund
University in Sweden.
"Such injuries may lead to an 'imbalance' in force transmissions
inside the knee joint, consequently overloading the joint cartilage
and leading to increased risk of developing osteoarthritis, compared
to injuries that mainly affect the outside of the knee joint, such
as contusions," Snoeker said by email.
Osteoarthritis often affects the large weight-bearing joints and can
eventually lead to the need for total joint replacement, the
researchers note in the British Journal of Sports Medicine.
Known risk factors include being overweight, older, female or having
a job that puts a lot of stress on the joints, the study team notes.
While a history of knee injuries is also a known risk factor,
research to date hasn't offered a clear picture of whether certain
types of injuries might be more likely to lead to osteoarthritis.
Two-thirds of the people in the study with knee injuries were male.
After 19 years of follow-up, 422 people with knee injuries, or
11.3%, developed knee osteoarthritis. So did 2,854, or 4%, of people
without knee injuries.
Most often, injuries involved multiple structures of the knee; this
accounted for 21% of participant knee injuries. The second most
common type of injury was cuts and contusions, at 18%, followed by
cartilage or other tissue tears at 17%.
Cruciate ligament injuries, or damage to the tissue connecting the
thighbone to the shinbone, were associated with a 19.6% greater risk
of knee osteoarthritis, the study also found. Meniscal tears, or
damage to cartilage connecting the same two bones, were associated
with a 10.5% greater risk of osteoarthritis. Fractures of the
shinbone where it meets the knee, or of the kneecap, were associated
with a 6.6% greater risk.
[to top of second column] |
Injuries involving multiple structures in the knee may have been
underreported, leading researchers to underestimate the risk
associated with these types of injuries, Jonas Bloch Thorlund, a
professor of musculoskeletal health at the University of Southern
Denmark, in Odense, who wasn't involved in the study, said by email.
Another limitation is that researchers didn't look at patient's body
mass index (BMI), so they couldn't tell whether differences in
weight might explain patients' risk of osteoarthritis, said Dr. Kyle
Hammond of the Emory Sports Medicine Center in Atlanta.
What happens after knee injuries can also influence the risk of
osteoarthritis down the line, Hammond, who wasn't involved in the
study, said by email.
"Counseling a patient on how to safely and consistently return to a
positive fitness program ensures that they will maintain flexibility
and strength, as well as keeping their weight at their ideal body
weight," Hammond advised.
Rehab matters regardless of what other treatments patients receive,
said Adam Culvenor, a sports and exercise medicine researcher at La
Trobe University in Bundoora, Australia, who wasn't involved in the
study.
"Once these injuries occur, optimally managing them with an intense
and progressive period of rehabilitation under the guidance of a
physical therapist (irrespective of the decision to have surgery or
not) to strengthen the muscles around the knee to facilitate a
return to function and physical activity is likely to reduce the
risk of osteoarthritis and persistent symptoms longer-term,"
Culvenor said by email.
SOURCE: https://bit.ly/2MhjRto British Journal of Sports Medicine,
online December 11, 2019.
[© 2019 Thomson Reuters. All rights
reserved.] Copyright 2019 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
