Dhillon Jaydeep, Kraeutler Matthew J, Belk John W, Scillia Anthony J, McCarty Eric C, Ansah-Twum Jeremy K, McCulloch Patrick C
Rocky Vista University College of Osteopathic Medicine, Parker, Colorado, USA.
Department of Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA.
Orthop J Sports Med. 2023 Mar 1;11(3):23259671231152900. doi: 10.1177/23259671231152900. eCollection 2023 Mar.
Some studies have suggested that running increases the risk of knee osteoarthritis (OA), while others believe it serves a protective function.
To perform an updated systematic review of the literature to determine the effects of running on the development of knee OA.
Systematic review; Level of evidence, 4.
A systematic review was performed by searching the PubMed, Cochrane Library, and Embase databases to identify studies evaluating the effect of cumulative running on the development of knee OA or chondral damage based on imaging and/or patient-reported outcomes (PROs). The search terms used were "knee AND osteoarthritis AND (run OR running OR runner)." Patients were evaluated based on plain radiographs, magnetic resonance imaging (MRI), and PROs (presence of knee pain, Health Assessment Questionnaire-Disability Index, and the Knee injury and Osteoarthritis Outcome Score).
Seventeen studies (6 level 2 studies, 9 level 3 studies, and 2 level 4 studies), with 7194 runners and 6947 nonrunners, met the inclusion criteria. The mean follow-up time was 55.8 months in the runner group and 99.7 months in the nonrunner group. The mean age was 56.2 years in the runner group and 61.6 years in the nonrunner group. The overall percentage of men was 58.5%. There was a significantly higher prevalence of knee pain in the nonrunner group ( < .0001). Although 1 study found a significantly higher prevalence of osteophytes in the tibiofemoral (TF) and patellofemoral (PF) joints within the runner group, multiple studies found no significant differences in the prevalence of radiographic knee OA (based on TF/PF joint-space narrowing or Kellgren-Lawrence grade) or cartilage thickness on MRI between runners and nonrunners ( > .05). One study found a significantly higher risk of knee OA progressing to total knee replacement among nonrunners (4.6% vs 2.6%; = .014).
In the short term, running is not associated with worsening PROs or radiological signs of knee OA and may be protective against generalized knee pain.
一些研究表明跑步会增加膝关节骨关节炎（OA）的风险，而另一些研究则认为跑步具有保护作用。
对文献进行更新的系统评价，以确定跑步对膝关节OA发展的影响。
系统评价；证据等级，4级。
通过检索PubMed、Cochrane图书馆和Embase数据库进行系统评价，以识别基于影像学和/或患者报告结局（PROs）评估累积跑步对膝关节OA发展或软骨损伤影响的研究。使用的检索词为“膝关节 AND 骨关节炎 AND（跑步 OR 赛跑 OR 跑步者）”。基于X线平片、磁共振成像（MRI）和PROs（膝关节疼痛的存在、健康评估问卷 - 残疾指数以及膝关节损伤和骨关节炎结局评分）对患者进行评估。
17项研究（6项2级研究、9项3级研究和2项4级研究），共纳入7194名跑步者和6947名非跑步者，符合纳入标准。跑步者组的平均随访时间为55.8个月，非跑步者组为99.7个月。跑步者组的平均年龄为56.2岁，非跑步者组为61.6岁。男性总体占比为58.5%。非跑步者组膝关节疼痛的患病率显著更高（<0.0001）。尽管1项研究发现跑步者组胫股（TF）和髌股（PF）关节骨赘的患病率显著更高，但多项研究发现跑步者和非跑步者之间，影像学膝关节OA的患病率（基于TF/PF关节间隙变窄或Kellgren - Lawrence分级）或MRI上的软骨厚度无显著差异（>0.05）。1项研究发现非跑步者中膝关节OA进展为全膝关节置换的风险显著更高（4.6%对2.6%；P = 0.014）。
短期内，跑步与膝关节OA的PROs恶化或放射学征象无关，可能对全身性膝关节疼痛具有保护作用。
