Are Running Athletes at Risk of Knee Osteoarthritis in later Life?

Abstract

Introduction: Osteoarthritis (OA) is one of the most common causes of disability in developed countries. Longdistance and marathon running are relatively safe sports. A natural progression is that the joints of runners subject to repetitive loading would at some point of time fail due to OA. The aim of this narrative review is to explore the association between running and the development of knee OA.

Method: A search of MEDLINE, EMBASE and Cochrane Databases was performed in July 2014. The authors further canvassed the reference list of selected articles and online search engines such as Google Scholar. An inclusion criterion was studies that assessed the prevalence and/or incidence of knee OA in athletes (competitive or amateur).

Results and Discussion: Animal data suggests that intrinsic injury or excessive exercise leads to a higher incidence of OA, however, moderate exercise may offer a protective effect against OA. Running athletes can be divided into two groups based on age at which they began running: early age athletes and middle-to-older age athletes. For early athletes there is conflicting data about the prevalence of knee OA or earlier OA. It appears that despite worse radiological OA, clinically these patients are no different to non-running younger people in later life. For the middle-older age runners, running as a tool of exercise is not associated with increased risk of knee OA and may in turn provide a protective effect against a variety of chronic diseases in the elderly.

Conclusion: Middle to older age patients should be encouraged to pursue running to improve overall fitness and explained about the non-impact on earlier knee OA as is commonly perceived by the population. For the younger athletes, further work is needed to conclusively prove an association or non-association.