Former male elite athletes have a higher prevalence of osteoarthritis and arthroplasty in the hip and knee than expected

Am J Sports Med. 2012 Mar;40(3):527-33. doi: 10.1177/0363546511429278. Epub 2011 Nov 30.


Background: Intense exercise has been reported as one risk factor for hip and knee osteoarthritis (OA).

Purpose: This study aimed to evaluate (1) whether this is true for both former impact and nonimpact athletes, (2) if the risk of a hip or knee arthroplasty due to OA is higher than expected, and (3) if joint deterioration is associated with knee injuries.

Study design: Cohort study; Level of evidence, 3.

Methods: The prevalence of OA and arthroplasty in the hip and knee were registered in 709 former male elite athletes with a median age of 70 years (range, 50-93 years), retired from sports for a median 35 years (range, 1-63 years), and compared with 1368 matched controls. Odds ratios (ORs) are presented as means with 95% confidence intervals (95% CIs).

Results: The risk of hip or knee OA was higher in former athletes (OR, 1.9; 95% CI, 1.5-2.3), as was arthroplasty based on OA in either of these joints (OR, 2.2; 95% CI, 1.6-3.1). The risk of hip OA was doubled (OR, 2.0; 95% CI, 1.5-2.8) and hip arthroplasty was 2.5 times higher (OR, 2.5; 95% CI, 1.6-3.7) in former athletes than in controls, predominantly driven by a higher risk in former impact athletes. Also, the risk of knee OA was higher (OR, 1.6; 95% CI, 1.3-2.1), as was knee arthroplasty (OR, 1.6; 95% CI, 0.9-2.7), driven by a higher risk in both former impact and nonimpact athletes. Knee OA in impact athletes was associated with knee injury.

Conclusion: Hip and knee OA and hip and knee arthroplasty are more commonly found in former male elite athletes than expected. A previous knee injury is associated with knee OA in former impact athletes but not in nonimpact athletes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / statistics & numerical data*
  • Arthroplasty, Replacement, Knee / statistics & numerical data*
  • Athletes / statistics & numerical data*
  • Athletic Injuries / epidemiology
  • Athletic Injuries / surgery
  • Cohort Studies
  • Hip Injuries / epidemiology
  • Hip Injuries / surgery
  • Humans
  • Knee Injuries / epidemiology
  • Knee Injuries / surgery
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / epidemiology*
  • Osteoarthritis, Hip / surgery
  • Osteoarthritis, Knee / epidemiology*
  • Osteoarthritis, Knee / surgery
  • Prevalence