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Lo GH, Richard MJ, Kriska AM, McAlindon TE, Harkey M, Rockette-Wagner B, Eaton CB, Hochberg MC, Kwoh CK, Nevitt MC, Bhakta PB, McLaughlin CP, Driban JB. Bicycling over a Lifetime Is Associated with Less Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Med Sci Sports Exerc 2024; 56:1678-1684. [PMID: 38600648 PMCID: PMC11326993 DOI: 10.1249/mss.0000000000003449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
INTRODUCTION This study aimed to evaluate the relationship between a history of bicycling and symptomatic and structural outcomes of knee osteoarthritis (OA), the most common form of arthritis. METHODS This was a retrospective, cross-sectional study within the Osteoarthritis Initiative (OAI), where we investigated OAI participants with complete data on bicycling, knee pain, and radiographic evidence of knee OA. We used a self-administered questionnaire at the 96-month OAI visit to identify participation in bicycling during four time periods throughout a participant's lifetime (ages 12-18, 19-34, 35-49, and >50 yr). Using logistic regression, we evaluated the influence of prior bicycling status (any history, history for each time period, number of periods cycling) on three outcomes at the 48-month OAI visit: frequent knee pain, radiographic OA (ROA), and symptomatic radiographic OA (SOA), adjusting for age and gender. RESULTS A total of 2607 participants were included: 44.2% were male, mean age was 64.3 (SD, 9.0) yr, and body mass index was 28.5 (SD, 4.9) kg·m -2 . The adjusted risk ratios for the outcome of frequent knee pain, ROA, and SOA among those who reported any history of bicycling compared with non-bicyclers were 0.83 (0.73-0.92), 0.91 (0.85-0.98), and 0.79 (0.68-0.90), respectively. We observed a dose-response among those who participated in bicycling during more time periods. CONCLUSIONS People who participated in bicycling had a lower prevalence of frequent knee pain, ROA, and SOA. The benefit appeared cumulative. This study indicates that bicycling may be favorable to knee health and should be encouraged.
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Affiliation(s)
- Grace H. Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX
- Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Medical Center, Houston, TX
| | - Michael J. Richard
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA
| | - Andrea M. Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA
| | - Matthew Harkey
- Department of Kinesiology, Michigan State University, East Lansing, MI
| | | | - Charles B. Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI
- Department of Epidemiology, School of Public Health of Brown University, Providence, RI
| | - Marc C. Hochberg
- Department of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - C. Kent Kwoh
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | | | | | - Jeffrey B. Driban
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA
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Lo GH, Richard MJ, McAlindon TE, Kriska AM, Price LL, Rockette-Wagner B, Eaton CB, Hochberg MC, Kent Kwoh C, Nevitt MC, Driban JB. Strength Training Is Associated With Less Knee Osteoarthritis: Data From the Osteoarthritis Initiative. Arthritis Rheumatol 2024; 76:377-383. [PMID: 37870119 PMCID: PMC10922276 DOI: 10.1002/art.42732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/14/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE We aimed to evaluate the relationship of a history of strength training with symptomatic and structural outcomes of knee osteoarthritis (OA). METHODS This study was a retrospective, cross-sectional study within the Osteoarthritis Initiative (OAI), a multicenter prospective longitudinal observational study. Data were collected at four OAI clinical sites: Memorial Hospital of Rhode Island, the Ohio State University, the University of Pittsburgh, and the University of Maryland/Johns Hopkins. The study included 2,607 participants with complete data on strength training, knee pain, and radiographic evidence of knee OA (male, 44.2%; mean ± SD age 64.3 ± 9.0 years; mean ± SD body mass index 28.5 ± 4.9 kg/m2 ). We used a self-administered questionnaire at the 96-month OAI visit to evaluate the exposure of strength training participation during four time periods throughout a participant's lifetime (ages 12-18, 19-34, 35-49, and ≥50 years old). The outcomes (dependent variables) were radiographic OA (ROA), symptomatic radiographic OA (SOA), and frequent knee pain. RESULTS The fully adjusted odds ratios (95% confidence interval) for frequent knee pain, ROA, and SOA among those who participated in strength training any time in their lives were 0.82 (0.68-0.97), 0.83 (0.70-0.99), and 0.77 (0.63-0.94), respectively. Findings were similar when looking at the specific age ranges. CONCLUSION Strength training is beneficial for future knee health, counteracting long-held assumptions that strength training has adverse effects.
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Affiliation(s)
- Grace H. Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX
- Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Medical Center, Houston, TX, USA
| | - Michael J. Richard
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Andrea M. Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lori Lyn Price
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | | | - Charles B. Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI and Department of Epidemiology, School of Public Health of Brown University, Providence, RI
| | - Marc C. Hochberg
- Department of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - C. Kent Kwoh
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
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Xu D, Van Middelkoop M, Bierma-Zeinstra SMA, Runhaar J. Physical Activity and Features of Knee Osteoarthritis on Magnetic Resonance Imaging in Individuals Without Osteoarthritis: A Systematic Review. Arthritis Care Res (Hoboken) 2023; 75:1908-1913. [PMID: 36576386 DOI: 10.1002/acr.25083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 12/07/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To systematically review all studies that have evaluated the association between physical activity (PA) levels and features of knee osteoarthritis (OA) on magnetic resonance imaging (MRI) for subjects without OA. METHODS The inclusion criteria for prospective studies were as follows: 1) subjects without OA; 2) average age 35-80 years; and 3) any self-reported PA or objective measurement of PA. The eligible MRI outcomes were OA-related measures of intraarticular knee joint structures. Exclusion criteria were evaluations of instant associations with transient structural changes after PA. RESULTS Two randomized controlled trials and 16 observational studies were included. One of 11 studies found that PA was harmfully related to cartilage volume or thickness, but 4 studies found a significant protective association. Four of 10 studies found that PA was harmfully related to cartilage defects, while others showed no significant associations. Two of 3 studies reported a significantly increased cartilage T2 value in individuals with more PA. All 3 studies reported no significant association between PA and bone marrow lesions. Two studies assessed the association between PA and meniscus pathology, in which only occupational PA involving knee bending was associated with a greater risk of progression. CONCLUSION Within the sparse and diverse evidence available, no strong evidence was found for the presence or absence of an association between PA and the presence or progression of features of OA on MRI among subjects without OA. Therefore, more research is required before PA in general and also specific forms of PA can be deemed safe for knee joint structures.
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Affiliation(s)
- Dawei Xu
- Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | | | - Jos Runhaar
- Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Nunez L, Jeelani S, Timaran-Montenegro D, Riascos R, McCarty J. Characterization of acute American football spinal injuries in a multi-center healthcare system. Emerg Radiol 2022; 29:1003-1008. [PMID: 36169728 DOI: 10.1007/s10140-022-02089-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/12/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE American football is considered one of the more injury-prone sports given its high-speed and high-impact nature. While much attention has been focused on chronic traumatic encephalopathy, spinal injuries represent the most common catastrophic injury incurred in football. The goal of this investigation is to describe the most common football-associated spinal lesions in a multi-center health system. METHODS This is a retrospective analysis of patients with imaging evidence of spinal injuries related to American football during a 10-year period. Injuries were classified based on the anatomic level, type injury, spinal cord compromise, and therapeutic management. Chi-squared and Fisher's exact test were used for statistical analysis of categorial variables, and simple logistic regression was used to determine individual odds ratios. RESULTS A total of 71 patients were included, with a median age of 17 (IQR, 15-22) years. The cervical spine was the most frequently affected segment (46%), followed by lumbar spine injuries (45%), and thoracic spine injuries (10%). Discogenic injuries were identified in 45 patients (63%). Spinal cord injury was documented in 7 subjects (10%), while cauda equina compression was reported in 1 patient (1%). CONCLUSIONS Acute spinal injuries continue to represent a significant cause of morbidity among American football players. Compared to national statistics, we found a similar distribution of spinal injuries in terms of anatomic location and an alarmingly high proportion of SCI. This investigation represents the largest single-center study addressing spinal injuries among football players.
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Affiliation(s)
- Luis Nunez
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA
| | - Salmaan Jeelani
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA
| | - David Timaran-Montenegro
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA
| | - Roy Riascos
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA
| | - Jennifer McCarty
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin St, MSB 2.130B, Houston, TX, 77030, USA.
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Webster KE, Hewett TE. Anterior Cruciate Ligament Injury and Knee Osteoarthritis: An Umbrella Systematic Review and Meta-analysis. Clin J Sport Med 2022; 32:145-152. [PMID: 33852440 DOI: 10.1097/jsm.0000000000000894] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/31/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To conduct a systematic review of reviews to summarize the (1) risk for development and (2) prevalence of knee osteoarthritis (OA) after anterior cruciate ligament (ACL) injury and surgical treatment and (3) compare prevalence rates between surgical and nonsurgical treatment of ACL injury. DATE SOURCES Five electronic databases were searched using medical subject heading and text words up to February 2020 to identify English language reviews. STUDY SELECTION Studies were included if they were a systematic review or meta-analysis. DATA EXTRACTION Thirteen eligible reviews were included, and the main outcome extracted was knee OA prevalence or risk data and any meta-analysis results. DATA SYNTHESIS Results from reviews were combined with a summary meta-analysis based on odds ratios (ORs) or proportions. There was a near 7-fold and 8-fold increase in the odds for the development of knee OA post ACL injury [OR = 6.81 (5.70-8.13)] and ACL reconstruction [OR = 7.7, (6.05-9.79)]. Data were too heterogenous to specify a point estimate prevalence for OA after ACL injury, but OA prevalence was estimated at 36% (19.70-53.01) at near 10 years after reconstruction surgery. A significantly higher prevalence of OA was found for those who received surgical treatment at a minimum 10-year follow-up [OR = 1.40 (1.17-1.68)]. CONCLUSIONS This study combines all data from previous systematic reviews into a single source to show that ACL injury markedly increases the risk for development of knee OA, which is likely to be present in the long term in approximately a third of patients who have reconstruction surgery. Surgical treatment does not reduce OA prevalence in the longer term compared with nonsurgical treatment.
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Affiliation(s)
- Kate E Webster
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne Vic, Australia ; and
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Gonarthrose: Erhöhtes Risiko durch American Football im Teenageralter. SPORTVERLETZUNG-SPORTSCHADEN 2020. [DOI: 10.1055/a-1190-9318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kiningham RB. Latest Clinical Research Published by ACSM. Curr Sports Med Rep 2020. [DOI: 10.1249/jsr.0000000000000706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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