J Knee Surg 2012; 25(05): 403-406
DOI: 10.1055/s-0032-1313753
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Knee Sports Injury Is Associated with an Increased Prevalence of Unilateral Knee Replacement: A Case-Controlled Study

Fotios Paul Tjoumakaris
1   Department of Orthopaedic Surgery, Thomas Jefferson University, Rothman Institute, New Jersey
,
Jonathan Van Kleunen
2   Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
,
Zachary Weidner
2   Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
,
George Russell Huffman
2   Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

07 July 2011

27 November 2011

Publication Date:
15 May 2012 (online)

Abstract

Injury to the knee during athletics is common and may limit future sports participation, but its long-term effects on patients are less well characterized. Examining the development of end-stage osteoarthritis (OA) in these patients may help better clarify this relationship. We hypothesize that sports-related knee injuries are associated with subsequent unilateral knee OA and need for total knee arthroplasty (TKA) relative to bilateral knee replacement. We present a single-hospital case–control study of 124 consecutive patients undergoing primary TKA over a 6-month period for end-stage OA. Patients were interviewed at the time of surgery using a standardized questionnaire to detect and characterize a history of athletic knee injury. The presence of contralateral knee arthritis based on preoperative assessment was noted for all patients. A control population was derived from patients with diagnosed or known bilateral OA undergoing TKA. Patients were all assessed for exposure to earlier sports or athletic injury. Prestudy power analysis and uni- and multivariate statistical analyses were performed. Of the 124 patients, 27 (22%) recorded a history of athletic knee injury. Evidence of bilateral significant knee OA was found in 73 patients and unilateral arthritis in 51 patients. Patients with unilateral OA were found to have an increased likelihood of previous athletic injury relative to those with bilateral disease (odds ratio: 6.08, p = 0.0001). There is a significant prevalence of sports-related injuries in patients with unilateral knee OA. This study suggests that patients with such injuries may develop arthritis via a different process, sports-related trauma, than patients with bilateral nontraumatic OA.

 
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