Background: To assess the relationship between sport and osteoarthritis, and specifically to determine whether previous participation, in terms of level (elite or non-elite), type of sport, intensity or previous injury were associated with osteoarthritis. Methods: This systematic review was developed using PRISMA guidelines. Databases were searched (to May 2016). Narrative review and meta-analysis (with risk ratio (RR) and 95% confidence intervals (CI)) approaches were undertaken where appropriate. Study quality was assessed using GRADE. Results: Forty-six studies were included. Narratively, 31 studies reported an increased risk of osteoarthritis, with 19 demonstrating an increased risk in elite athletes. There was an increased risk after sports exposure (irrespective of type) (RR:1.37; 95% CI:1.14, 1.64; 21 studies). It remained uncertain whether there was a difference in risk of osteoarthritis between elite and non-elite athletes (RR:1.37; 95% CI:0.84, 2.22; 17 studies). Risk was higher in soccer (RR:1.42; 95% CI:1.14, 1.77; 15 studies), but lower runners (RR:0.86; 95% CI:0.53, 1.41; 12 studies). Nine studies showed an association with the intensity of sport undertaken and osteoarthritis. Five studies demonstrated a higher prevalence of osteoarthritis following meniscectomies and anterior cruciate ligament tears. Overall the evidence was of GRADE 'very low' quality. Conclusions: There was very low quality evidence to support an increased relationship between sports participation and osteoarthritis in elite participants. It is unclear whether there is a difference in risk between elite and non-elite participants with further prospective studies needed to evaluate this. Pooled findings suggested significant injuries were associated with OA in soccer players.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)