J Orthop Sports Phys Ther. 2017 Jun;47(6):373-390. doi: 10.2519/jospt.2017.7137. Epub 2017 May 13.
Study Design Systematic review and meta-analysis. Background Running is a healthy and popular activity worldwide, but data regarding its association with osteoarthritis (OA) are conflicting. Objectives To evaluate the association of hip and knee OA with running and to explore the influence of running intensity on this association. Methods PubMed, Embase, and Cochrane Library databases were used to identify studies investigating the occurrence of OA of the hip and/or knee among runners. A meta-analysis of studies comparing this occurrence between runners and controls (sedentary, nonrunning individuals) was conducted. Runners were regarded as "competitive" if they were reported as professional/elite athletes or participated in international competitions. Recreational runners were individuals running in a nonprofessional (amateur) context. The prevalence rate and odds ratio (with 95% confidence interval [CI]) for OA between runners (at competitive and recreational levels) and controls were calculated. Subgroup analyses were conducted for OA location (hip or knee), sex, and years of exposure to running (less or more than 15 years). Results Twenty-five studies (n = 125810 individuals) were included and 17 (n = 114829 individuals) were meta-analyzed. The overall prevalence of hip and knee OA was 13.3% (95% CI: 11.6%, 15.2%) in competitive runners, 3.5% (95% CI: 3.4%, 3.6%) in recreational runners, and 10.2% (95% CI: 9.9%, 10.6%) in controls. The odds ratio for hip and/or knee OA in competitive runners was higher than that in recreational runners (1.34; 95% CI: 0.97, 1.86 and 0.86; 95% CI: 0.69, 1.07, respectively; controls as reference group; for difference, P<.001). Exposure to running of less than 15 years was associated with a lower association with hip and/or knee OA compared with controls (OR = 0.6; 95% CI: 0.49, 0.73). Conclusion Recreational runners had a lower occurrence of OA compared with competitive runners and controls. These results indicated that a more sedentary lifestyle or long exposure to high-volume and/or high-intensity running are both associated with hip and/or knee OA. However, it was not possible to determine whether these associations were causative or confounded by other risk factors, such as previous injury. Level of Evidence Etiology/harm, level 2a. J Orthop Sports Phys Ther 2017;47(6):373-390. doi:10.2519/jospt.2017.7137.
系统评价和荟萃分析。
跑步是一项在全球范围内健康且流行的活动，但有关其与骨关节炎（OA）之间关联的数据却存在矛盾。
评估髋关节和膝关节 OA 与跑步之间的关系，并探讨跑步强度对这种关系的影响。
使用 PubMed、Embase 和 Cochrane 图书馆数据库来确定研究跑步与髋关节和/或膝关节 OA 发生之间关联的研究。对比较跑步者和对照组（久坐、非跑步个体）之间 OA 发生率的研究进行荟萃分析。如果报告为专业/精英运动员或参加国际比赛，则将跑步者视为“竞技”。娱乐性跑步者是指在非专业（业余）环境中跑步的个体。计算 OA 在跑步者（竞技和娱乐性水平）和对照组之间的患病率和比值比（95%置信区间[CI]）。进行了亚组分析，以研究 OA 的位置（髋关节或膝关节）、性别和跑步暴露年限（少于或多于 15 年）。
共纳入 25 项研究（n=125810 人），其中 17 项（n=114829 人）进行了荟萃分析。竞技跑步者髋关节和膝关节 OA 的总体患病率为 13.3%（95%CI：11.6%，15.2%），娱乐性跑步者为 3.5%（95%CI：3.4%，3.6%），对照组为 10.2%（95%CI：9.9%，10.6%）。竞技跑步者髋关节和/或膝关节 OA 的比值比高于娱乐性跑步者（1.34；95%CI：0.97，1.86 和 0.86；95%CI：0.69，1.07，分别；以对照组为参考组；差异 P<.001）。与对照组相比，跑步暴露年限少于 15 年与髋关节和/或膝关节 OA 的相关性较低（OR=0.6；95%CI：0.49，0.73）。
与竞技跑步者和对照组相比，娱乐性跑步者发生 OA 的几率较低。这些结果表明，更久坐的生活方式或长时间接触高容量和/或高强度的跑步都与髋关节和/或膝关节 OA 有关。然而，尚无法确定这些关联是由其他风险因素（如既往损伤）引起的，还是因果关系。
病因学/危害，2a 级。
美国骨科运动物理治疗杂志 2017；47（6）：373-390.doi：10.2519/jospt.2017.7137.
