Osteoarthritis of the knee in retired, elite Australian Rules footballers.

OBJECTIVE

To determine the functional and radiological status of knee joints of retired Australian Rules footballers compared with those of active community members.

DESIGN

Retrospective cohort study.

PARTICIPANTS

Fifty retired elite footballers aged 34-85 years (mean, 53.7 years; SD, 11.4) from four AFL clubs and 50 age-matched controls (35-79 years; mean, 55.7 years; SD, 12.4) who had played no contact sport since their teenage years.

MAIN OUTCOME MEASURES

Severity of knee functional osteoarthritis as determined by a questionnaire, and assessment of osteoarthritis by posteroanterior weight-bearing radiographs taken of both knees of each participant in 45-degree flexion.

RESULTS

After adjusting for age, height, weight and body mass index, footballers had a significantly greater prevalence (P < 0.0001) and severity (P < 0.05) of functional and radiological osteoarthritis than controls. Footballers with a history of intraarticular ligamentous and/or meniscal injury (Group 1) had a greater risk of functional osteoarthritis (P = 0.002) and radiological (P = 0.067) osteoarthritis than those with a history of collateral ligament injury or no injury (Group 2). Compared with controls, the odds of developing moderate to severe levels of functional and radiological osteoarthritis were 6.9 times (95% CI, 1.6-29.7; P = 0.01) and 105.0 times (95% CI, 11.8-931.8; P < 0.0001), respectively, those in Group 1 footballers and 3.6 times (95% CI, 0.8-16.2; P = 0.10) and 17.7 times (95% CI, 2.2-146.2; P = 0.0075), respectively, those in Group 2 footballers.

CONCLUSIONS

Elite Australian Rules footballers have a significant risk of both functional and radiological osteoarthritis, and a history of intra-articular ligament or meniscal injury increases this risk.