Knee function after a mean of 19 years Post-retirement in 65 Italian semi-professional rugby veterans.
Keywords:
Osteoarthritis, sport injury, ACL, meniscus, rugby, age of retire, veterans, Oxford Knee Score, SF-12, VASAbstract
Background and aim sport activity has been largely correlated to the development of knee osteoarthritis, but only few papers have investigated the long-term impact of a rugby career on the knee joint. The aim of this retrospective study was to evaluate the incidence and epidemiology of knee osteoarthritis and general health in a population of 65 retired semi-professional rugby players.
Methods demographic and anamnestic analysis was recorded and Oxford Knee score, SF-12 and VAS were submitted to all veterans in order to assess current knee function, general health condition and level of pain. Parametric analysis of Spearman was used to evaluate the statistical significance on these results and the Kruskal-Wallis test was used to assess the significant differences between the questionnaire results and the demographic and anamnestic records.
Results we found that players who sustained a knee injury during their career have a current reduction of the knee function compared to veterans who did not suffer any injury and who showed values comparable with those of the health population. In terms of general and mental health, athletes who retired later have now a better condition than those who retired from the sport earlier.
Conclusions: we concluded that knee injury prevention should be an unequivocal priority because although rugby is a high energy sport, it does not increase the risk of knee osteoarthritis in absence of serious knee injuries.
References
Glyn-Jones S, Palmer AJ, Agricola R, et Al. Osteoarthritis. Lancet. 2015 Jul 25;386(9991):376-87. doi: 10.1016/S0140-6736(14)60802-3.
Johnson VL, Hunter DJ. The epidemiology of osteoarthritis. Best Pract Res Clin Rheumatol 2014; 28(1):5-15. doi: 10.1016/j.berh.2014.01.004.
Palmer JS, Monk AP, Hopewell S et Al. Surgical interventions for symptomatic mild to moderate knee osteoarthritis. Cochrane Database of Systematic Reviews 2019, Issue 7. Art. No.: CD012128. DOI: 10.1002/14651858.CD012128.pub2.
Mancò A, Goderecci R, Rughetti A et Al. Microfracture versus microfracture and platelet-rich plasma: arthroscopic treatment of knee chondral lesions. A two-year follow-up study. Joints 2016; 21;4(3):142-147. doi: 10.11138/jts/2016.4.3.142.
Molloy MG, Molloy CB. Contact sport and osteoarthritis. Br J Sports Med. 2011; 45(4):275-7. doi: 10.1136/bjsm.2011.083956.
Vannini F, Spalding T, Andriolo L, et al. Sport and early osteoarthritis: the role of sport in aetiology, progression and treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2016; 24(6):1786-1796. DOI: 10.1007/s00167-016-4090-5.
Lee R, Kean WF. Obesity and knee osteoarthritis. Inflammopharmacology 2012; 20(2):53-8. doi: 10.1007/s10787-011-0118-0.
Roos EM, Arden NK. Strategies for the prevention of knee osteoarthritis. Nat Rev Rheumatol. 2016; 12(2):92-101. doi: 10.1038/nrrheum.2015.135
Muthuri SG, McWilliams DF, Doherty M, Zhang W. History of knee injuries and knee osteoarthritis: a meta-analysis of observational studies. Osteoarthritis Cartilage 2011 ;19(11):1286-93. doi: 10.1016/j.joca.2011.07.015.
Simon D, Mascarenhas R, Saltzman BM, Rollins M, Bach BR Jr, MacDonald P. The Relationship between Anterior Cruciate Ligament Injury and Osteoarthritis of the Knee. Adv Orthop 2015; 2015:928301. doi: 10.1155/2015/928301.
Marie-Therese K. Kuijt, Han Inklaar, Vincent Gouttebarge, Monique H.W. Frings-Dresen. Knee and ankle osteoarthritis in former elite soccer players: A systematic review of the recent literature. Sci Med Sport 2012; 5(6):480-7. doi: 10.1016/j.jsams.2012.02.008
Petrillo S, Papalia R, Maffulli N, Volpi P, Denaro V. Osteoarthritis of the hip and knee in former male professional soccer players. Br Med Bull. 2018; 125(1):121-130. doi: 10.1093/bmb/ldy001. PMID: 29385409.
Lohkamp M, Kromer TO, Schmitt H. Osteoarthritis and joint replacements of the lower limb and spine in ex-professional soccer players: A systematic review. Scand J Med Sci Sports 2017; 27(10):1038-1049. doi: 10.1111/sms.12846.
Davies MAM, D Judge A, Delmestri A et Al. Health amongst former rugby union players: A cross-sectional study of morbidity and health-related quality of life. Sci Rep 2017; 7(1):11786. doi: 10.1038/s41598-017-12130-y.
Gouttebarge V, Inklaar H, Frings-Dresen MH. Risk and consequences of osteoarthritis after a professional football career: a systematic review of the recent literature. J Sports Med Phys Fitness 2014 ;54(4):494-504.
Hind K, Konerth N, Entwistle I et Al. Cumulative Sport-Related Injuries and Longer Term Impact in Retired Male Elite- and Amateur-Level Rugby Code Athletes and Non-contact Athletes: A Retrospective Study. Sports Med 2020; 50(11):2051-2061. doi: 10.1007/s40279-020-01310-y.
King DA, Hume PA, Milburn PD, Guttenbeil D. Match and training injuries in rugby league: a review of published studies. Sports Med 2010; 40(2):163-78. doi: 10.2165/11319740-000000000-00000.
Dallalana RJ, Brooks JH, Kemp SP, Williams AM. The epidemiology of knee injuries in English professional rugby union. Am J Sports Med 2007; 35(5):818-30. doi: 10.1177/0363546506296738.
Calvisi Vittorio, Remo Goderecci and Stefano Necozione. "Rugby Injuries: Epidemiology and Mechanism." Arthroscopy and Sport Injuries. Springer, Cham, 2016. 25-31.
Murray DW, Fitzpatrick R, Rogers K, et Al. The use of the Oxford hip and knee scores. J Bone Joint Surg Br. 2007; 89(8):1010-4. doi: 10.1302/0301-620X.89B8.19424.
Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996 Mar;34(3):220-33. doi: 10.1097/00005650-199603000-00003.
K. Lee, G.M. Keickhefer Measuring human responses using visual analogue scales West J Nurs Res, 11 (1989), pp. 128-132
Brooks JH, Fuller CW, Kemp SP, Reddin DB. Epidemiology of injuries in English professional rugby union: part 1 match injuries. Br J Sports Med 2005; 39(10):757-66. doi: 10.1136/bjsm.2005.018135.
Targett SG. Injuries in professional Rugby Union. Clin J Sport Med 1998; 8(4):280-5. doi: 10.1097/00042752-199810000-00005.
Bathgate A, Best JP, Craig G, Jamieson M. A prospective study of injuries to elite Australian rugby union players. Br J Sports Med 2002; 36(4):265-9; discussion 269. doi: 10.1136/bjsm.36.4.265.
Quarrie KL, Hopkins WG. Changes in player characteristics and match activities in Bledisloe Cup rugby union from 1972 to 2004. J Sports Sci 2007; 25(8):895-903. doi: 10.1080/02640410600944659.
Bell DR, Pfeiffer KA, Cadmus-Bertram LA et Al. Objectively Measured Physical Activity in Patients After Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2017; 45(8):1893-1900. doi: 10.1177/0363546517698940
Abbate LM, Jordan JM. Weight change in osteoarthritis. Osteoarthritis Cartilage 2012; 20(4):268-70. doi: 10.1016/j.joca.2011.11.017.
de Oliveira FCL, Roy JS, Pappas E. ACL injury, physical activity, and overweight/obesity: a vicious cycle? Knee Surg Sports Traumatol Arthrosc 2020; 28(3):667-669. doi: 10.1007/s00167-019-05807-6.
Delincé P, Ghafil D. Anterior cruciate ligament tears: conservative or surgical treatment? A critical review of the literature. Knee Surg Sports Traumatol Arthrosc.
; 20(1):48-61. doi: 10.1007/s00167-011-1614-x.
Barenius B, Ponzer S, Shalabi A, et Al. Increased risk of osteoarthritis after anterior cruciate ligament reconstruction: a 14-year follow-up study of a randomized controlled trial. Am J Sports Med 2014; 42(5):1049-57. doi: 10.1177/0363546514526139.
Salzmann GM, Preiss S, Zenobi-Wong M et Al. Osteoarthritis in Football. Cartilage. 2017; 8(2):162-172. doi: 10.1177/1947603516648186.
Gouttebarge V, Inklaar H, Backx F, Kerkhoffs G. Prevalence of osteoarthritis in former elite athletes: a systematic overview of the recent literature. Rheumatol Int 2015; 35(3):405-18. doi: 10.1007/s00296-014-3093-0.
McLean JM, Brumby-Rendell O, Lisle R et Al. Asymptomatic population reference values for three knee patient-reported outcomes measures: evaluation of an electronic data collection system and implications for future international, multi-centre cohort studies. Arch Orthop Trauma Surg 2018; 138(5):611-621. doi: 10.1007/s00402-018-2874-4.
Bremner-Smith AT, Ewings P, Weale AE. Knee scores in a 'normal' elderly population. Knee 2004; 11(4):279-82. doi: 10.1016/j.knee.2003.06.001.
Mehl J, Diermeier T, Herbst E et Al. Evidence-based concepts for prevention of knee and ACL injuries. 2017 guidelines of the ligament committee of the German Knee Society (DKG). Arch Orthop Trauma Surg. 2018; 138(1):51-61. doi: 10.1007/s00402-017-2809-5.
Bien DP. Rationale and implementation of anterior cruciate ligament injury prevention warm-up programs in female athletes. J Strength Cond Res 2011; 25(1):271-85. doi: 10.1519/JSC.0b013e3181fb4a5a.
Bisciotti GN, Chamari K, Cena E, et Al. ACL injury in football: a literature overview of the prevention programs. Muscles Ligaments Tendons J 2016; 6(4):473-479. doi: 10.11138/mltj/2016.6.4.473.
Hewett TE, Lindenfeld TN, Riccobene JV, Noyes FR. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med 1999; 27(6):699-706. doi: 10.1177/03635465990270060301.
Paxinos O, Karavasili A, Delimpasis G, Stathi A. Prevalence of Knee Osteoarthritis in 100 Athletically Active Veteran Soccer Players Compared With a Matched Group of 100 Military Personnel. Am J Sports Med 2016; 44(6):1447-54. doi: 10.1177/0363546516629648.
Ramzi S, Besharat M A. The impact of hardiness on sport achievement and mental health. Procedia-Social and Behavioral Sciences 2010; 5:823-826. doi:10.1016/j.sbspro.2010.07.192
Gouttebarge V, Castaldelli-Maia JM, Gorczynski P et Al. Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis. Br J Sports Med 2019; 53(11):700-706. doi: 10.1136/bjsports-2019-100671.
Menke DJ, Germany ML. Reconstructing athletic identity: College athletes and sport retirement. Journal of Loss and Trauma 2019; 24.1:17-0. Doi.org/10.1080/15325024.2018.1522475
Esopenko, C., Coury, J. R., Pieroth, E. M., et Al. The psychological burden of retirement from sport. Curr Sports Med Rep 2020; 19(10):430-437. doi: 10.1249/JSR.0000000000000761.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Remo Goderecci, Simone De Dominicis, Stefano Necozione, Vincenzo Ciriello, Massimo Angelozzi, Vittorio Calvisi, Giandomenico Logroscino
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
