Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jun 14;9(6):23259671211004554.
doi: 10.1177/23259671211004554. eCollection 2021 Jun.

Association of Sports Participation With Osteoarthritis: A Systematic Review and Meta-Analysis

Thomas Bestwick-Stevenson  1   2 , Onosi S Ifesemen  1 , Richard G Pearson  2 , Kimberley L Edwards  1   2
Affiliations
Review

Association of Sports Participation With Osteoarthritis: A Systematic Review and Meta-Analysis

Thomas Bestwick-Stevenson et al. Orthop J Sports Med. .

Abstract

Background: The association between participating in sport and osteoarthritis is not fully understood.

Purpose: To investigate the association between osteoarthritis and participating in sports not listed in previous reviews: American football, archery, baseball, bobsleigh, curling, handball, ice hockey, shooting, skeleton, speed skating, and wrestling.

Study design: Systematic review; Level of evidence, 3.

Methods: We searched 4 electronic databases and hand searched recent/in-press editions of relevant journals. The criteria for study selection were case-control studies, cohort studies, nested case-control studies, and randomized trials with a control group that included adults to examine the effect of exposure to any of the included sports on the development of osteoarthritis.

Results: The search returned 6197 articles after deduplication. Nine studies were included in the final review, covering hip, knee, and ankle osteoarthritis. There were no studies covering archery, baseball, skeleton, speed skating, or curling. The 6 sports included in the review were analyzed as a collective; the results of the meta-analysis indicated that participation in the sports analyzed was associated with an increased risk of developing osteoarthritis of the hip (relative risk [RR] = 1.67 [95% confidence interval (CI), 1.15-2.41]; P = .04), knee (RR = 1.60 [95% CI, 1.23-2.08]; P < .001), and ankle (RR = 7.08 [95% CI, 1.24-40.51]; P = .03) as compared with controls. Meta-analysis suggested a significantly increased likelihood of developing hip osteoarthritis through participating in wrestling (RR = 1.78 [95% CI, 1.20-2.64]; P = .004) and ice hockey (RR = 1.70 [95% CI, 1.27-2.29]; P < .001), while there was no significant difference through participating in handball (RR = 2.50 [95% CI, 0.85-7.36]; P = .10). Likelihood of developing knee osteoarthritis was significantly increased in wrestling (RR = 2.22 [95% CI, 1.59-3.11]) and ice hockey (RR = 1.52 [95% CI, 1.18-1.96]; both P < .002). According to the meta-analysis, shooting did not have a significant effect on the RR of knee osteoarthritis as compared with other sports (RR = 0.43 [95% CI, 0.06-2.99]; P = .39).

Conclusion: The likelihood of developing hip and knee osteoarthritis was increased for ice hockey and wrestling athletes, and the risk of developing hip osteoarthritis was increased for handball athletes. The study also found that participation in the sports examined, as a collective, resulted in an increased risk of developing hip, knee, and ankle osteoarthritis.

Keywords: osteoarthritis; sport; systematic review.

PubMed Disclaimer

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This study was supported financially by the Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis (formerly the Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis; grant 21595) and was supported by the NIHR Nottingham Biomedical Research Centre. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart of search results.
Figure 2.
Figure 2.
Relationship between sport and (A) hip osteoarthritis, (B) knee osteoarthritis, and (C) ankle osteoarthritis. M-H, Mantel-Haenszel.
Figure 3.
Figure 3.
Forest plots assessing the risk of hip osteoarthritis after participation in ice hockey (elite and nonelite) as compared with a control group: (A) sports in control group and (B) no sports in control group. Forest plots assessing the risk of knee osteoarthritis after participation in ice hockey (elite and nonelite) as compared with a control group: (C) sports in control group and (D) no sports in control group. M-H, Mantel-Haenszel.
Figure 4.
Figure 4.
Forest plots assessing the risk of hip osteoarthritis after participation in wrestling (elite and nonelite) as compared with a control group: (A) sports in control group and (B) no sports in control group. Forest plots assessing the risk of knee osteoarthritis after participation in wrestling (elite and nonelite) as compared with a control group: (C) sports in control group and (D) no sports in control group. M-H, Mantel-Haenszel.
Figure 5.
Figure 5.
Forest plots assessing the risk of hip osteoarthritis after participation in handball (elite and nonelite) as compared with a control group: (A) sports in control group and (B) no sports in control group. M-H, Mantel-Haenszel.
Figure 6.
Figure 6.
Forest plot assessing the risk of knee osteoarthritis after participation in shooting (elite and nonelite) as compared with a control group (including sports). M-H, Mantel-Haenszel.
See this image and copyright information in PMC

References

    1. Adams JE. Injury to the throwing arm—a study of traumatic changes in the elbow joints of boy baseball players. Calif Med. 1965;102(2):127–132. - PMC - PubMed
    1. Agricola R, Bessems JH, Ginai AZ, et al. The development of cam-type deformity in adolescent and young male soccer players. Am J Sports Med. 2012;40(5):1099–1106. - PubMed
    1. Axe M, Newcomb W, Warner D. Sports injuries and adolescent athletes. Del Med J. 1991;63(6):359–363. - PubMed
    1. Ayeni OR, Banga K, Bhandari M, et al. Femoroacetabular impingement in elite ice hockey players. Knee Surg Sports Traumatol Arthrosc. 2014;22(4):920–925. - PubMed
    1. Ayis S, Dieppe P. The natural history of disability and its determinants in adults with lower limb musculoskeletal pain. J Rheumatol. 2009;36(3):583–591. - PubMed

LinkOut - more resources