Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Sport and early osteoarthritis: the role of sport in aetiology, progression and treatment of knee osteoarthritis

Abstract

Sports activities are considered favourable for general health; nevertheless, a possible influence of sports practice on the development of early osteoarthritis (OA) is a cause for concern. A higher incidence of OA in knees and ankles of former high-impact sports players than in those of the normal population has been shown and it is still debatable whether the cause is either to be recognized generically in the higher number of injuries or in a joint overload. The possibility to address knee OA in its early phases may be strictly connected to the modification of specific extrinsic or intrinsic factors, related to the patient in order to save the joint from further disease progression; these include sport practice, equipment and load. Non-surgical therapies such as continuative muscles reinforce and training play a strong role in the care of athletes with early OA, particularly if professional. There is an overall agreement on the need of an early restoring of a proper meniscal, ligament and cartilage integrity in order to protect the knee and resume sports safely, whereas alignment is a point still strongly debatable especially for professional athletes. Remaining questions still to be answered are the risks of different sports in relation to one another, although an actual protective effect of low-impact sports, such as walking, swimming or cycling, has been recognized on the appearance or worsening of OA, the effect of continuing or ceasing to practice a sport on the natural history of early OA, and even following appropriate treatment is still unknown.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Adams T, Band-Entrup D, Kuhn S, Legere L, Mace K, Paggi A, Penney M (2013) Physical therapy management of knee osteoarthritis in the middle-aged athlete. Sports Med Arthrosc 21(1):2–10

  2. 2.

    Ajuied A, Wong F, Smith C, Norris M, Earnshaw P, Back D, Davies A (2014) Anterior cruciate ligament injury and radiologic progression of knee osteoarthritis: a systematic review and meta-analysis. Am J Sports Med 42(9):2242–2252

  3. 3.

    Alvarez-Diaz P, Alentorn-Geli E, Llobet F, Granados N, Steinbacher G, Cugat R (2014) Return to play after all-inside meniscal repair in competitive football players: a minimum 5-year follow-up. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3285-x

  4. 4.

    Anderson DD, Chubinskaya S, Guilak F, Martin JA, Oegema TR, Olson SA, Buckwalter JA (2011) Post-traumatic osteoarthritis: improved understanding and opportunities for early intervention. J Orthop Res 29(6):802–809

  5. 5.

    Ardern CL, Webster KE, Taylor NF, Feller JA (2011) Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med 45(7):596–606

  6. 6.

    Arliani GG, Astur DC, Yamada RK, Yamada AF, Miyashita GK, Mandelbaum B, Cohen M (2014) Early osteoarthritis and reduced quality of life after retirement in former professional soccer players. Clinics (Sao Paulo) 69(9):589–594

  7. 7.

    Arokoski JP, Jurvelin JS, Vaatainen U, Helminen HJ (2000) Normal and pathological adaptations of articular cartilage to joint loading. Scand J Med Sci Sports 10(4):186–198

  8. 8.

    Beckwee D, Vaes P, Shahabpour M, Muyldermans R, Rommers N, Bautmans I (2015) The influence of joint loading on bone marrow lesions in the knee: a systematic review with meta-analysis. Am J Sports Med 43(12):3093–3107

  9. 9.

    Berger MJ, McKenzie CA, Chess DG, Goela A, Doherty TJ (2012) Quadriceps neuromuscular function and self-reported functional ability in knee osteoarthritis. J Appl Physiol 113(2):255–262

  10. 10.

    Bergmann G, Graichen F, Rohlmann A (1993) Hip joint loading during walking and running, measured in two patients. J Biomech 26(8):969–990

  11. 11.

    Bonnin MP, Laurent JR, Zadegan F, Badet R, Pooler Archbold HA, Servien E (2013) Can patients really participate in sport after high tibial osteotomy? Knee Surg Sports Traumatol Arthrosc 21(1):64–73

  12. 12.

    Brinkman JM, Lobenhoffer P, Agneskirchner JD, Staubli AE, Wymenga AB, van Heerwaarden RJ (2008) Osteotomies around the knee: patient selection, stability of fixation and bone healing in high tibial osteotomies. J Bone Joint Surg Br 90(12):1548–1557

  13. 13.

    Brown TD, Anderson DD, Nepola JV, Singerman RJ, Pedersen DR, Brand RA (1988) Contact stress aberrations following imprecise reduction of simple tibial plateau fractures. J Orthop Res 6(6):851–862

  14. 14.

    Brown TD, Pope DF, Hale JE, Buckwalter JA, Brand RA (1991) Effects of osteochondral defect size on cartilage contact stress. J Orthop Res 9(4):559–567

  15. 15.

    Brown TD, Shaw DT (1983) In vitro contact stress distributions in the natural human hip. J Biomech 16(6):373–384

  16. 16.

    Buckwalter JA (2003) Sports, joint injury, and posttraumatic osteoarthritis. J Orthop Sports Phys Ther 33(10):578–588

  17. 17.

    Buckwalter JA, Lane NE (1997) Athletics and osteoarthritis. Am J Sports Med 25(6):873–881

  18. 18.

    Buckwalter JA, Martin JA, Brown TD (2006) Perspectives on chondrocyte mechanobiology and osteoarthritis. Biorheology 43(3–4):603–609

  19. 19.

    Buda R, Vannini F, Cavallo M, Grigolo B, Cenacchi A, Giannini S (2010) Osteochondral lesions of the knee: a new one-step repair technique with bone-marrow-derived cells. J Bone Joint Surg Am 92(Suppl 2):2–11

  20. 20.

    Chakravarty EF, Hubert HB, Lingala VB, Zatarain E, Fries JF (2008) Long distance running and knee osteoarthritis: a prospective study. Am J Prev Med 35(2):133–138

  21. 21.

    Chang A, Hayes K, Dunlop D, Song J, Hurwitz D, Cahue S, Sharma L (2005) Hip abduction moment and protection against medial tibiofemoral osteoarthritis progression. Arthritis Rheum 52(11):3515–3519

  22. 22.

    Chatain F, Adeleine P, Chambat P, Neyret P (2003) A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy 19(8):842–849

  23. 23.

    Chockalingam PS, Glasson SS, Lohmander LS (2013) Tenascin-C levels in synovial fluid are elevated after injury to the human and canine joint and correlate with markers of inflammation and matrix degradation. Osteoarthr Cartil 21(2):339–345

  24. 24.

    Cole GK, Nigg BM, van Den Bogert AJ, Gerritsen KG (1996) The clinical biomechanics award paper 1995 Lower extremity joint loading during impact in running. Clin Biomech (Bristol, Avon) 11(4):181–193

  25. 25.

    de David AC, Carpes FP, Stefanyshyn D (2015) Effects of changing speed on knee and ankle joint load during walking and running. J Sports Sci 33(4):391–397

  26. 26.

    Della Villa S, Kon E, Filardo G, Ricci M, Vincentelli F, Delcogliano M, Marcacci M (2010) Does intensive rehabilitation permit early return to sport without compromising the clinical outcome after arthroscopic autologous chondrocyte implantation in highly competitive athletes? Am J Sports Med 38(1):68–77

  27. 27.

    Demange MK, Sisto M, Rodeo S (2014) Future trends for unicompartmental arthritis of the knee: injectables & stem cells. Clin Sports Med 33(1):161–174

  28. 28.

    Deyle GD, Allison SC, Matekel RL, Ryder MG, Stang JM, Gohdes DD, Hutton JP, Henderson NE, Garber MB (2005) Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Phys Ther 85(12):1301–1317

  29. 29.

    Drawer S, Fuller CW (2001) Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br J Sports Med 35(6):402–408

  30. 30.

    Driban JB, Eaton CB, Lo GH, Ward RJ, Lu B, McAlindon TE (2014) Association of knee injuries with accelerated knee osteoarthritis progression: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 66(11):1673–1679

  31. 31.

    Elleuch MH, Guermazi M, Mezghanni M, Ghroubi S, Fki H, Mefteh S, Baklouti S, Sellami S (2008) Knee osteoarthritis in 50 former top-level soccer players: a comparative study. Ann Readapt Med Phys 51(3):174–178

  32. 32.

    Faschingbauer M, Nelitz M, Urlaub S, Reichel H, Dornacher D (2015) Return to work and sporting activities after high tibial osteotomy. Int Orthop 39(8):1527–1534

  33. 33.

    Feucht MJ, Minzlaff P, Saier T, Cotic M, Sudkamp NP, Niemeyer P, Imhoff AB, Hinterwimmer S (2014) Degree of axis correction in valgus high tibial osteotomy: proposal of an individualised approach. Int Orthop 38(11):2273–2280

  34. 34.

    Filardo G, Andriolo L, Kon E, de Caro F, Marcacci M (2015) Meniscal scaffolds: results and indications: a systematic literature review. Int Orthop 39(1):35–46

  35. 35.

    Filardo G, Di Matteo B, Di Martino A, Merli ML, Cenacchi A, Fornasari P, Marcacci M, Kon E (2015) Platelet-rich plasma intra-articular knee injections show no superiority versus viscosupplementation: a randomized controlled trial. Am J Sports Med 43(7):1575–1582

  36. 36.

    Filardo G, Kon E, Di Martino A, Patella S, Altadonna G, Balboni F, Bragonzoni L, Visani A, Marcacci M (2012) Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 20(9):1704–1713

  37. 37.

    Filardo G, Kon E, Perdisa F, Tetta C, Di Martino A, Marcacci M (2015) Arthroscopic mosaicplasty: long-term outcome and joint degeneration progression. Knee 22(1):36–40

  38. 38.

    Filardo G, Kon E, Roffi A, Di Matteo B, Merli ML, Marcacci M (2015) Platelet-rich plasma: why intra-articular? A systematic review of preclinical studies and clinical evidence on PRP for joint degeneration. Knee Surg Sports Traumatol Arthrosc 23(9):2459–2474

  39. 39.

    Flanigan DC, Harris JD, Trinh TQ, Siston RA, Brophy RH (2010) Prevalence of chondral defects in athletes’ knees: a systematic review. Med Sci Sports Exerc 42(10):1795–1801

  40. 40.

    Fransen M, McConnell S (2009) Land-based exercise for osteoarthritis of the knee: a metaanalysis of randomized controlled trials. J Rheumatol 36(6):1109–1117

  41. 41.

    Gauffin H, Rockborn P (2014) Knee dislocations: is reconstruction of the posterior cruciate ligament crucial? Eur J Orthop Surg Traumatol 24(3):371–377

  42. 42.

    Giannini S, Buda R, Battaglia M, Cavallo M, Ruffilli A, Ramponi L, Pagliazzi G, Vannini F (2013) One-step repair in talar osteochondral lesions: 4-year clinical results and t2-mapping capability in outcome prediction. Am J Sports Med 41(3):511–518

  43. 43.

    Giuliani JR, Burns TC, Svoboda SJ, Cameron KL, Owens BD (2011) Treatment of meniscal injuries in young athletes. J Knee Surg 24(2):93–100

  44. 44.

    Hambly K, Silvers HJ, Steinwachs M (2012) Rehabilitation after articular cartilage repair of the knee in the football (soccer) player. Cartilage 3(Suppl 1):50S–56S

  45. 45.

    Kim SG, Nagao M, Kamata K, Maeda K, Nozawa M (2013) Return to sport after arthroscopic meniscectomy on stable knees. BMC Sports Sci Med Rehabil 5(1):23

  46. 46.

    Kon E, Delcogliano M, Filardo G, Altadonna G, Marcacci M (2009) Novel nano-composite multi-layered biomaterial for the treatment of multifocal degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 17(11):1312–1315

  47. 47.

    Kon E, Filardo G, Berruto M, Benazzo F, Zanon G, Della Villa S, Marcacci M (2011) Articular cartilage treatment in high-level male soccer players: a prospective comparative study of arthroscopic second-generation autologous chondrocyte implantation versus microfracture. Am J Sports Med 39(12):2549–2557

  48. 48.

    Konradsen L, Hansen EM, Sondergaard L (1990) Long distance running and osteoarthrosis. Am J Sports Med 18(4):379–381

  49. 49.

    Kotsovolos ES, Hantes ME, Mastrokalos DS, Lorbach O, Paessler HH (2006) Results of all-inside meniscal repair with the FasT-Fix meniscal repair system. Arthroscopy 22(1):3–9

  50. 50.

    Krajnc Z, Vogrin M, Recnik G, Crnjac A, Drobnic M, Antolic V (2010) Increased risk of knee injuries and osteoarthritis in the non-dominant leg of former professional football players. Wien Klin Wochenschr 122(Suppl 2):40–43

  51. 51.

    Kuijt MT, Inklaar H, Gouttebarge V, Frings-Dresen MH (2012) Knee and ankle osteoarthritis in former elite soccer players: a systematic review of the recent literature. J Sci Med Sport 15(6):480–487

  52. 52.

    Kujala UM, Kaprio J, Sarna S (1994) Osteoarthritis of weight bearing joints of lower limbs in former elite male athletes. BMJ 308(6923):231–234

  53. 53.

    Lafeber FP, van Spil WE (2013) Osteoarthritis year 2013 in review: biomarkers; reflecting before moving forward, one step at a time. Osteoarthr Cartil 21(10):1452–1464

  54. 54.

    Lane NE, Bloch DA, Jones HH, Marshall WH Jr, Wood PD, Fries JF (1986) Long-distance running, bone density, and osteoarthritis. JAMA 255(9):1147–1151

  55. 55.

    Lee HH, Chu CR (2012) Clinical and basic science of cartilage injury and arthritis in the football (soccer) athlete. Cartilage 3(Suppl 1):63S–68S

  56. 56.

    Lee YS, Lim BO, Kim JG, Lee KK, Park HO, An KO, Ryew CC, Kim JH (2011) Serial assessment of knee joint moments in posterior cruciate ligament and posterolateral corner reconstructed patients during a turn running task. Arch Orthop Trauma Surg 131(3):335–341

  57. 57.

    Lequesne MG, Dang N, Lane NE (1997) Sport practice and osteoarthritis of the limbs. Osteoarthr Cartil 5(2):75–86

  58. 58.

    Lobenhoffer P, Agneskirchner JD (2003) Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 11(3):132–138

  59. 59.

    Luc B, Gribble PA, Pietrosimone BG (2014) Osteoarthritis prevalence following anterior cruciate ligament reconstruction: a systematic review and numbers-needed-to-treat analysis. J Athl Train 49(6):806–819

  60. 60.

    Marcacci M, Filardo G, Kon E (2013) Treatment of cartilage lesions: what works and why? Injury 44(Suppl 1):S11–S15

  61. 61.

    Marcacci M, Marcheggiani Muccioli GM, Grassi A, Ricci M, Tsapralis K, Nanni G, Bonanzinga T, Zaffagnini S (2014) Arthroscopic meniscus allograft transplantation in male professional soccer players: a 36-month follow-up study. Am J Sports Med 42(2):382–388

  62. 62.

    Marcacci M, Zaffagnini S, Marcheggiani Muccioli GM, Grassi A, Bonanzinga T, Nitri M, Bondi A, Molinari M, Rimondi E (2012) Meniscal allograft transplantation without bone plugs: a 3-year minimum follow-up study. Am J Sports Med 40(2):395–403

  63. 63.

    Marsh JL, Buckwalter J, Gelberman R, Dirschl D, Olson S, Brown T, Llinias A (2002) Articular fractures: does an anatomic reduction really change the result? J Bone Joint Surg Am 84(7):1259–1271

  64. 64.

    Minzlaff P, Feucht MJ, Saier T, Cotic M, Plath JE, Imhoff AB, Hinterwimmer S (2014) Can young and active patients participate in sports after osteochondral autologous transfer combined with valgus high tibial osteotomy? Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3447-x

  65. 65.

    Mithoefer K, Hambly K, Della Villa S, Silvers H, Mandelbaum BR (2009) Return to sports participation after articular cartilage repair in the knee: scientific evidence. Am J Sports Med 37(Suppl 1):167S–176S

  66. 66.

    Murawski CD, van Eck CF, Irrgang JJ, Tashman S, Fu FH (2014) Operative treatment of primary anterior cruciate ligament rupture in adults. J Bone Joint Surg Am 96(8):685–694

  67. 67.

    Otsuki S, Nakajima M, Okamoto Y, Oda S, Hoshiyama Y, Iida G, Neo M (2016) Correlation between varus knee malalignment and patellofemoral osteoarthritis. Knee Surg Sports Traumatol Arthrosc 24(1):176–181

  68. 68.

    Pape D, Adam F, Rupp S, Seil R, Kohn D (2004) Stability, bone healing and loss of correction after valgus realignment of the tibial head: a roentgen stereometry analysis. Orthopade 33(2):208–217

  69. 69.

    Perdisa F, Filardo G, Di Matteo B, Di Martino A, Marcacci M (2014) Biological knee reconstruction: a case report of an Olympic athlete. Eur Rev Med Pharmacol Sci 18(Suppl 1):76–80

  70. 70.

    Puddu G, Cipolla M, Cerullo G, Franco V, Gianni E (2007) Osteotomies: the surgical treatment of the valgus knee. Sports Med Arthrosc 15(1):15–22

  71. 71.

    Rand JA, Neyret P (2005) ISAKOS meeting on the management of osteoarthritis of the knee prior to total knee arthroplasty. Paper presented at the ISAKOS congress, Hollywood, Florida

  72. 72.

    Rodkey WG, DeHaven KE, Montgomery WH 3rd, Baker CL Jr, Beck CL Jr, Hormel SE, Steadman JR, Cole BJ, Briggs KK (2008) Comparison of the collagen meniscus implant with partial meniscectomy: a prospective randomized trial. J Bone Joint Surg Am 90(7):1413–1426

  73. 73.

    Rotterud JH, Reinholt FP, Beckstrom KJ, Risberg MA, Aroen A (2014) Relationship between CTX-II and patient characteristics, patient-reported outcome, muscle strength, and rehabilitation in patients with a focal cartilage lesion of the knee: a prospective exploratory cohort study of 48 patients. BMC Musculoskelet Disord 15:99

  74. 74.

    Hosnijeh FS, Runhaar J, van Meurs JB, Bierma-Zeinstra SM (2015) Biomarkers for osteoarthritis: can they be used for risk assessment? A systematic review. Maturitas 82(1):36–49

  75. 75.

    Salzmann GM, Ahrens P, Naal FD, El-Azab H, Spang JT, Imhoff AB, Lorenz S (2009) Sporting activity after high tibial osteotomy for the treatment of medial compartment knee osteoarthritis. Am J Sports Med 37(2):312–318

  76. 76.

    Saragaglia D, Rouchy RC, Krayan A, Refaie R (2014) Return to sports after valgus osteotomy of the knee joint in patients with medial unicompartmental osteoarthritis. Int Orthop 38(10):2109–2114

  77. 77.

    Saxon L, Finch C, Bass S (1999) Sports participation, sports injuries and osteoarthritis: implications for prevention. Sports Med 28(2):123–135

  78. 78.

    Segal NA, Glass NA, Torner J, Yang M, Felson DT, Sharma L, Nevitt M, Lewis CE (2010) Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort. Osteoarthr Cartil 18(6):769–775

  79. 79.

    Seil R, van Heerwaarden R, Lobenhoffer P, Kohn D (2013) The rapid evolution of knee osteotomies. Knee Surg Sports Traumatol Arthrosc 21(1):1–2

  80. 80.

    Shakoor N, Sengupta M, Foucher KC, Wimmer MA, Fogg LF, Block JA (2010) Effects of common footwear on joint loading in osteoarthritis of the knee. Arthritis Care Res (Hoboken) 62(7):917–923

  81. 81.

    Spector TD, Harris PA, Hart DJ, Cicuttini FM, Nandra D, Etherington J, Wolman RL, Doyle DV (1996) Risk of osteoarthritis associated with long-term weight-bearing sports: a radiologic survey of the hips and knees in female ex-athletes and population controls. Arthritis Rheum 39(6):988–995

  82. 82.

    Spindler KP, Huston LJ, Wright RW, Kaeding CC, Marx RG, Amendola A, Parker RD, Andrish JT, Reinke EK, Harrell FE Jr, Dunn WR (2011) The prognosis and predictors of sports function and activity at minimum 6 years after anterior cruciate ligament reconstruction: a population cohort study. Am J Sports Med 39(2):348–359

  83. 83.

    Staubli AE, De Simoni C, Babst R, Lobenhoffer P (2003) TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia—early results in 92 cases. Injury 34(Suppl 2):B55–B62

  84. 84.

    van Dijk CN, Lim LS, Poortman A, Strubbe EH, Marti RK (1995) Degenerative joint disease in female ballet dancers. Am J Sports Med 23(3):295–300

  85. 85.

    Van Ginckel A, Verdonk P, Victor J, Witvrouw E (2013) Cartilage status in relation to return to sports after anterior cruciate ligament reconstruction. Am J Sports Med 41(3):550–559

  86. 86.

    Van Spil WE, Nair SC, Kinds MB, Emans PJ, Hilberdink WK, Welsing PM, Lafeber FP (2015) Systemic biochemical markers of joint metabolism and inflammation in relation to radiographic parameters and pain of the knee: data from CHECK, a cohort of early-osteoarthritis subjects. Osteoarthr Cartil 23(1):48–56

  87. 87.

    Van Spil WE, Welsing PM, Bierma-Zeinstra SM, Bijlsma JW, Roorda LD, Cats HA, Lafeber FP (2015) The ability of systemic biochemical markers to reflect presence, incidence, and progression of early-stage radiographic knee and hip osteoarthritis: data from CHECK. Osteoarthr Cartil 23(8):1388–1397

  88. 88.

    Vundelinckx B, Vanlauwe J, Bellemans J (2014) Long-term subjective, clinical, and radiographic outcome evaluation of meniscal allograft transplantation in the knee. Am J Sports Med 42(7):1592–1599

  89. 89.

    W-Dahl A, Toksvig-Larsen S, Lindstrand A (2015) Ten-year results of physical activity after high tibial osteotomy in patients with knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-015-3693-6

  90. 90.

    Weng MC, Lee CL, Chen CH, Hsu JJ, Lee WD, Huang MH, Chen TW (2009) Effects of different stretching techniques on the outcomes of isokinetic exercise in patients with knee osteoarthritis. Kaohsiung J Med Sci 25(6):306–315

  91. 91.

    Woo SL, Abramowitch SD, Kilger R, Liang R (2006) Biomechanics of knee ligaments: injury, healing, and repair. J Biomech 39(1):1–20

  92. 92.

    Xie X, Liu X, Chen Z, Yu Y, Peng S, Li Q (2015) A meta-analysis of bone-patellar tendon-bone autograft versus four-strand hamstring tendon autograft for anterior cruciate ligament reconstruction. Knee 22(2):100–110

  93. 93.

    Yaniv M, Becker T, Goldwirt M, Khamis S, Steinberg DM, Weintroub S (2006) Prevalence of bowlegs among child and adolescent soccer players. Clin J Sport Med 16(5):392–396

  94. 94.

    Zaffagnini S, Marcheggiani Muccioli GM, Grassi A, Bonanzinga T, Filardo G, Passalacqua AC, Marcacci M (2011) Arthroscopic lateral collagen meniscus implant in a professional soccer player. Knee Surg Sports Traumatol Arthrosc 19(10):1740–1743

  95. 95.

    Zaffagnini S, Marcheggiani Muccioli GM, Lopomo N, Bruni D, Giordano G, Ravazzolo G, Molinari M, Marcacci M (2011) Prospective long-term outcomes of the medial collagen meniscus implant versus partial medial meniscectomy: a minimum 10-year follow-up study. Am J Sports Med 39(5):977–985

Download references

Author information

Correspondence to F. Vannini.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Vannini, F., Spalding, T., Andriolo, L. et al. Sport and early osteoarthritis: the role of sport in aetiology, progression and treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 24, 1786–1796 (2016). https://doi.org/10.1007/s00167-016-4090-5

Download citation

Keywords

  • Sport
  • Early osteoarthritis
  • Knee
  • Degeneration
  • Cartilage