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Knee Arthritis in Ex-Footballers

  • Stefano ZaffagniniEmail author
  • Tommaso Roberti di Sarsina
  • F. Raggi
  • A. Grassi
  • T. Bonanzinga
  • G. Marcheggiani Muccioli
  • M. Marcacci

Abstract

Osteoarthritis is the most common joint disease. Being exposed to high-intensity and prolonged sports activity, footballers are particularly vulnerable to osteoarthritis as a long-term effect of such vigorous physical stress, resulting in irreversible pathological changes in affected joints.

The main symptoms are joint pain, stiffness, dysfunction, instability, deformity, swelling, and crepitus. Those symptoms can be presented early in an athlete career and lead to sport dismissal.

The etiology of osteoarthritis is multifactorial and not fully understood.

In this chapter we are focusing on those mechanical factors that accelerate such process.

We will go through malalignment, loss of meniscal tissue, cartilage defects, and joint instability, focusing on conservative or surgical treatment and on the impact of such treatment on return to sport.

Keywords

Knee Footballers Varus knee Malalignment Meniscal loss 

References

  1. 1.
    Loeser RF (2010) Age-related changes in the musculoskeletal system and the development of osteoarthritis. Clin Geriatr Med 26:371–386CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Buckwalter JA, Martin JA, Brown TD (2006) Perspectives on chondrocyte mechanobiology and osteoarthritis. Biorheology 43:603–660PubMedGoogle Scholar
  3. 3.
    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):392–396CrossRefPubMedGoogle Scholar
  4. 4.
    Tetsworth K, Paley D (1994) Malalignment and degenerative arthropathy. Orthop Clin North Am 25:367–377PubMedGoogle Scholar
  5. 5.
    Brouwer GM, van Tol AW, Bergink AP, Belo JN, Bernsen RM, Reijman M, Pols HA, Bierma-Zeinstra SM (2007) Association between valgus and varus alignment and the development and progression of radiographic osteoarthritis of the knee. Arthritis Rheum 56:1204–1211CrossRefPubMedGoogle Scholar
  6. 6.
    Cicuttini F, Wluka A, Hankin J, Wang Y (2004) Longitudinal study of the relationship between knee angle and tibiofemoral cartilage volume in subjects with knee osteoarthritis. Rheumatology (Oxford) 43:321–324CrossRefGoogle Scholar
  7. 7.
    Heijink A, Gomoll AH, Madry H, Drobnič M, Filardo G, Espregueira-Mendes J, Van Dijk CN (2012) Biomechanical considerations in the pathogenesis of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 20(3):423–435CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Roos EM, Ostenberg A, Roos H, Ekdahl C, Lohmander LS (2001) Long-term outcome of meniscectomy: symptoms, function, and performance tests in patients with or without radiographic osteoarthritis compared to matched controls. Osteoarthritis Cartilage 9:316–324CrossRefPubMedGoogle Scholar
  9. 9.
    Alford JW, Lewis P, Kang RW, Cole BJ (2005) Rapid progression of chondral disease in the lateral compartment of the knee following meniscectomy. Arthroscopy 21:1505–1509CrossRefPubMedGoogle Scholar
  10. 10.
    van Dijk CN, Tol JL, Struijs PAA (1997) Complications, rehabilitation and results of arthroscopic meniscectomy and meniscal repair: a review of the literature. J Sports Traumatol Relat Res 19:43–50Google Scholar
  11. 11.
    Ahmed AM, Burke DL (1983) In vitro measurement of static pressure distribution in synovial joints – part I: tibial surface of the knee. J Biomech Eng 105:216–225CrossRefPubMedGoogle Scholar
  12. 12.
    Baratz ME, Fu FH, Mengato R (1986) Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med 14:270–275CrossRefPubMedGoogle Scholar
  13. 13.
    Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Joint Surg Br 30B:664–670PubMedGoogle Scholar
  14. 14.
    Jackson JP (1968) Degenerative changes in the knee after meniscectomy. Br Med J 2:525–527CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Voloshin AS, Wosk J (1983) Shock absorption of meniscectomized and painful knees: a comparative in vivo study. J Biomed Eng 5:157–161CrossRefPubMedGoogle Scholar
  16. 16.
    Buckwalter JA (2002) Articular cartilage injuries. Clin Orthop Relat Res 402:21–37CrossRefPubMedGoogle Scholar
  17. 17.
    Ding C, Cicuttini F, Scott F, Boon C, Jones G (2005) Association of prevalent and incident knee cartilage defects with loss of tibial and patellar cartilage: a longitudinal study. Arthritis Rheum 52:3918–3927CrossRefPubMedGoogle Scholar
  18. 18.
    Heir S, Nerhus TK, Rotterud JH, Loken S, Ekeland A, Engebretsen L, Aroen A (2010) Focal cartilage defects in the knee impair quality of life as much as severe osteoarthritis: a comparison of knee injury and osteoarthritis outcome score in 4 patient categories scheduled for knee surgery. Am J Sports Med 38:231–237CrossRefPubMedGoogle Scholar
  19. 19.
    Lohmander LS, Ostenberg A, Englund M, Roos H (2004) High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 50:3145–3152CrossRefPubMedGoogle Scholar
  20. 20.
    Kerkhof HJ, Meulenbelt I, Akune T, Arden NK, Aromaa A, Bierma-Zeinstra SM et al (2011) Recommendations for standardization and phenotype definitions in genetic studies of osteoarthritis: the TREAT-OA consortium. Osteoarthritis Cartilage 3:254–264CrossRefGoogle Scholar
  21. 21.
    Felson DT, Niu J, Guermazi A, Sack B, Aliabadi P (2011) Defining radiographic incidence and progression of knee osteoarthritis: problems with the Kellgren and Lawrence scale. Ann Rheum Dis 70:1884–1886CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Hollander JL (1951) The local effects of compound F (hydro cortisone) injected into joints. Bull Rheum Dis 2:3–4PubMedGoogle Scholar
  23. 23.
    Miller JH, White J, Norton TH (1958) The value of intraarticular injections in osteoarthritis of the knee. J Bone Joint Surg Br 40-B:636–643PubMedGoogle Scholar
  24. 24.
    Kon E, Filardo G, Drobnic M, Madry H, Jelic M, van Dijk N, Della Villa S (2012) Non-surgical management of early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 20(3):436–449CrossRefPubMedGoogle Scholar
  25. 25.
    Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M (2010) Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 18:472–479CrossRefPubMedGoogle Scholar
  26. 26.
    Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M (2011) Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc 19:528–535CrossRefPubMedGoogle Scholar
  27. 27.
    Gomoll AH, Filardo G, Almqvist FK, Bugbee WD, Jelic M, Monllau JC, Puddu G, Rodkey WG, Verdonk P, Verdonk R, Zaffagnini S, Marcacci M (2012) Surgical treatment for early osteoarthritis. Part II: allografts and concurrent procedures. Knee Surg Sports Traumatol Arthrosc 20(3):468–486CrossRefPubMedGoogle Scholar
  28. 28.
    Gomoll AH, Filardo G, de Girolamo L, Espregueira-Mendes J, Marcacci M, Rodkey WG, Steadman JR, Zaffagnini S (2012) Kon E surgical treatment for early osteoarthritis. Part I: cartilage repair procedures. Knee Surg Sports Traumatol Arthrosc 20(3):450–466CrossRefPubMedGoogle Scholar
  29. 29.
    Marcacci M, Kon E, Delcogliano M, Filardo G, Busacca M, Zaffagnini S (2007) Arthroscopic autologous osteochondral grafting for cartilage defects of the knee: prospective study results at a minimum 7-year follow-up. Am J Sports Med 35:2014–2021CrossRefPubMedGoogle Scholar
  30. 30.
    Dozin B, Malpeli M, Cancedda R, Bruzzi P, Calcagno S, Molfetta L, Priano F, Kon E, Marcacci M (2005) Comparative evaluation of autologous chondrocyte implantation and mosaicplasty: a multicentered randomized clinical trial. Clin J Sport Med 15:220–226CrossRefPubMedGoogle Scholar
  31. 31.
    Hangody L, Dobos J, Baló E, Pánics G, Hangody LR, Berkes I (2010) Clinical experiences with autologous osteochondral mosaicplasty in an athletic population: a 17-year prospective multicenter study. Am J Sports Med 38:1125–1133Google Scholar
  32. 32.
    Cavallo C, Desando G, Facchini A, Grigolo B (2010) Chondrocytes from patients with osteoarthritis express typical extra- cellular matrix molecules once grown onto a three-dimensional hyaluronan-based scaffold. J Biomed Mater Res A 93:86–95PubMedGoogle Scholar
  33. 33.
    Filardo G, Kon E, Di Martino A, Patella S, Altadonna G, Balboni F, Visani A, Bragonzoni L, Marcacci M (2011) Second- generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions. A prospective 6-year follow-up study. Knee Surg Sports Traumatol Arthrosc. doi: 10.1007/s00167-011-1732-5 PubMedCentralGoogle Scholar
  34. 34.
    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 39:977–985CrossRefPubMedGoogle Scholar
  35. 35.
    Zaffagnini S, Marcheggiani Muccioli GM, Grassi A, Bonanzinga T, Filardo G, Canales Passalacqua A, Marcacci M (2011) Arthroscopic lateral collagen meniscus implant in a professional soccer player. Knee Surg Sports Traumatol Arthrosc 19:1740–1743CrossRefPubMedGoogle Scholar
  36. 36.
    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-months follow-up study. Am J Sports Med 42:382CrossRefPubMedGoogle Scholar
  37. 37.
    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. doi: 10.1016/j.jsams.2012.02.008, Epub 8 May 2012CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Stefano Zaffagnini
    • 1
    Email author
  • Tommaso Roberti di Sarsina
    • 1
  • F. Raggi
    • 1
  • A. Grassi
    • 1
  • T. Bonanzinga
    • 1
  • G. Marcheggiani Muccioli
    • 1
  • M. Marcacci
    • 1
  1. 1.Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione TecnologicaIstituto Ortopedico RizzoliBolognaItaly

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