Objectives: Football is the world biggest sport (7), and the estimates for ACL(Anterior Cruciate Ligament)-injuries varies; 0,06-3,7 for each 1000 playing-hours. (5,44) In Scandinavia football is the most common activity that leads to ACL-injury. (35) The objectives for this article are to investigate the radiological prevalence of osteoarthritis among former footballplayers, and the relation to ACL-injury.
Methods: The data and material are mainly from unsystematic searches in PubMed and Ovid Medline, and from the Norwegian National Knee Ligament Registry.
Results: In eight cohorts of former elite-players the knee osteoarthritis-prevalence were 29-80%. (16-21,28,29) The prevalence among elite-players might rise with later year of birth. (Figur 3) Two studies of nonelite-players also found football activity to be a significant risk factor for developing knee osteoarthritis. (22,29) Adjusted for previous knee injuries, there were still a significant difference between elite-players and the general population in seven of eight studies (17-21,28,29), but among non elite-players the significant difference disappeared. (22,29) Footballplayers with previous ACL-injury were found to have a knee osteoarthritis-prevalence at 31-77%, divided into subgroups there were a significant higher prevalence for ACL-injury combined with meniscectomy, 59-77% versus 31-39%. (26,32,33)
Conclusions: Former elite football players are at higher risk of developing knee osteoarthritis than the general population. Adjusted for knee injuries there are still a higher risk among elite-players. Football players with ACL-injuries and meniscectomy are at great risk of developing osteoarthritis. Players with ACL-injury, but without meniscectomy, are probably also more prone than football players without ACL-injury, but surveys comparing this two groups are not done. Challenges regarding this article are the lack of radiological standards (62), and the discrepancy between radiological and clinical osteoarthritis. (54)