Department of Surgical Sciences, Section of Orthopaedics, Uppsala University, Uppsala, Sweden.
PLoS One. 2011 Mar 30;6(3):e18339. doi: 10.1371/journal.pone.0018339.
To complete long-distance ski races, regular physical exercise is required. This includes not only cross-country skiing but also endurance exercise during the snow-free seasons. The aim of this study was to determine whether the level of physical exercise is associated with future risk of severe osteoarthritis independent of previous diseases and injuries.
METHODOLOGY/PRINCIPAL FINDINGS: We used a cohort that consisted of 48 574 men and 5 409 women who participated in the 90 km ski race Vasaloppet at least once between 1989 and 1998. Number of performed races and finishing time were used as estimates of exercise level. By matching to the National Patient Register we identified participants with severe osteoarthritis, defined as arthroplasty of knee or hip due to osteoarthritis. With an average follow-up of 10 years, we identified 528 men and 42 women with incident osteoarthritis. The crude rate was 1.1/1000 person-years for men and 0.8/1000 person-years for women. Compared with racing once, participation in ≥ 5 races was associated with a 70% higher rate of osteoarthritis (multivariable-adjusted hazard ratio (HR) 1.72, 95% confidence interval (CI) 1.33 to 2.22). The association was dose-dependent with an adjusted HR of 1.09, 95% CI 1.05 to 1.13 for each completed race. A faster finishing time, in comparison with a slow finishing time, was also associated with an increased rate (adjusted HR 1.51, 95% CI 1.14 to 2.01). Contrasting those with 5 or more ski races and a fast finish time to those who only participated once with a slow finish time, the adjusted HR of osteoarthritis was 2.73, 95% CI 1.78 to 4.18.
CONCLUSIONS/SIGNIFICANCE: Participants with multiple and fast races have an increased risk of subsequent arthroplasty of knee and hip due to osteoarthritis, suggesting that intensive exercise may increase the risk.
要完成长距离滑雪比赛，需要进行常规的体育锻炼。这不仅包括越野滑雪，还包括雪季之外的耐力运动。本研究旨在确定体育锻炼水平是否与未来严重骨关节炎的风险独立于既往疾病和损伤有关。
方法/主要发现：我们使用了一个队列，该队列包括 48574 名男性和 5409 名女性，他们在 1989 年至 1998 年间至少参加过一次 90 公里的滑雪比赛 Vasaloppet。参加比赛的次数和完赛时间被用作运动水平的估计。通过与国家患者登记处匹配，我们确定了患有严重骨关节炎的参与者，严重骨关节炎定义为膝关节或髋关节因骨关节炎而进行关节置换。平均随访 10 年后，我们发现 528 名男性和 42 名女性患有骨关节炎。男性的粗发病率为 1.1/1000 人年，女性为 0.8/1000 人年。与参加一次比赛相比，参加≥5 次比赛与骨关节炎发病率增加 70%相关（多变量调整后的风险比（HR）为 1.72，95%置信区间（CI）为 1.33 至 2.22）。这种关联呈剂量依赖性，每完成一次比赛，调整后的 HR 为 1.09（95%CI 为 1.05 至 1.13）。与完成时间较慢相比，完成时间较快也与发病率增加相关（调整后的 HR 为 1.51，95%CI 为 1.14 至 2.01）。与那些参加 5 次或更多滑雪比赛且完成时间较快的人相比，那些仅参加一次且完成时间较慢的人，骨关节炎的调整后 HR 为 2.73（95%CI 为 1.78 至 4.18）。
结论/意义：参加多次快速比赛的参与者因骨关节炎行膝关节和髋关节关节置换术的风险增加，这表明剧烈运动可能会增加这种风险。
