Abstract
Introduction
Elite and Olympian athletes are often stretching the upper limits of normal physiology and biomechanics of the musculoskeletal system in their efforts to excel in their sport. For them to get back to their sport at the same level after injury, the management, repair techniques, and rehabilitation protocols should be robust to permit healing of tissues to allow supra-normal loading and performance. The knee and the meniscus are commonly injured in these sports. Yet, the incidence, mechanisms, types of injuries to the meniscus, and their management are not known across different sports in the Olympics.
Methods
We set out to look into the incidence and the trends of publications on meniscal injuries of the knee in Olympic games. A search of the PubMed and Scopus for these injuries using a search strategy gave 79 and 116 articles, respectively.
Results
There were very few publications giving the incidence of meniscal injuries in the Olympics. Football is the sport with the highest rate of meniscal injuries. Different sports are popular in different countries, and depending on the popularity and the country reporting these injuries, incidences differed. There was data available from India and Brazil for Elite athlete from diverse sports, whereas most data from other countries were for football and soccer. Knee was found to be the second most commonly injured part of the body in both Winter and Summer Olympics as well as the Youth Winter Olympics. Data were not available from the Youth Summer Olympics to make any conclusions. The number of publications on this topic is low. We presented the timeline of publications and citations of articles on this topic. The top country, language, journal, university, and author were USA, English, American Journal of Sports Medicine, Hospital of Special Surgery in New York and Brophy RH, respectively. The data on the risk factors for meniscal injuries were analyzed, discussed, and presented for football, as this was the most extensively studied sport.
Conclusions
Even though the knee is one of the commonly injured anatomical locations in elite athletes, there is a lack of literature on meniscal injuries in this subset of population. We looked at possible reasons and made recommendations to improve data collection on these injuries.
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References
Chomiak, J., Junge, A., Peterson, L., & Dvorak, J. (2000). Severe injuries in football players. Influencing factors. American Journal of Sports Medicine,28, 58–68.
Nabhan, D., Walden, T., Street, J., Linden, H., Moreau, B. (2016) Sports injury and illness epidemiology during the 2014 Youth Olympic Games. British Journal of Sports Medicine, 50(11), 688–693.
Bromley, S. J., Drew, M. K., Talpey, S., McIntosh, A. S., & Finch, C. F. (2018). A systematic review of prospective epidemiological research into injury and illness in Olympic combat sport. British Journal of Sports Medicine,52(1), 8–16.
Dhillon, M.S., John, R., Sharma, S., Prabhakar, S., Behera, P., Saxena, S., et al. (2017) Epidemiology of knee injuries in Indian kabaddi players. Asian Journal of Sports Medicine, 8(1)
Engebretsen, L., Steffen, K., Alonso, J.M., Aubry, M., Dvorak, J., Junge, A., et al. (2010). Sports injuries and illnesses during the winter Olympic games 2010. British Journal of Sports Medicine, 44(11), 772–780.
Ruedl, G., Schobersberger, W., Pocecco, E., Blank, C., Engebretsen, L., Soligard, T., et al. (2012). Sport injuries and illnesses during the first Winter Youth Olympic Games 2012 in Innsbruck. Austria British Journal of Sports Medicine,46(15), 1030–1037.
Soligard, T., Steffen, K., Palmer-Green, D., Aubry, M., Grant, M. E., Meeuwisse, W., et al. (2015). Sports injuries and illnesses in the Sochi 2014 Olympic Winter Games. British Journal of Sports Medicine,49(7), 441–447.
Steffen, K., Moseid, C. H., Engebretsen, L., Soberg, P. K., Amundsen, O., Holm, K., et al. (2017). Sports injuries and illnesses in the Lillehammer 2016 Youth Olympic Winter Games. British Journal of Sports Medicine,51(1), 29–35.
Soligard, T., Palmer, D., Steffen, K., Lopes, A.D., Grant, M.E., Kim, D., et al. (2019). Sports injury and illness incidence in the PyeongChang 2018 Olympic Winter Games: A prospective study of 2914 athletes from 92 countries. British Journal of Sports Medicine, 1085–1092.
Edouard, P., Steffen, K., Junge, A., Leglise, M., Soligard, T., Engebretsen, L. (2018). Gymnastics injury incidence during the 2008, 2012 and 2016 Olympic Games. British Journal of Sports Medicine, 52(7), 475–481.
Junge, A., Langevoort, G., Pipe, A., Peytavin, A., Wong, F., Mountjoy, M., et al. (2006). Injuries in team sport tournaments during the 2004 Olympic Games. The American Journal of Sports Medicine,34(4), 565–576.
Athanasopoulos, S., Kapreli, E., Tsakoniti, A., Karatsolis, K., Diamantopoulos, K., Kalampakas, K., et al. (2007) The 2004 Olympic Games: physiotherapy services in the Olympic Village polyclinic. British Journal of Sports Medicine, 41(9), 603–609 (discussion 609).
Junge, A., Engebretsen, L., Mountjoy, M.L., Alonso, J.M., Renström, P.A.F.H., Aubry, M.J., et al. (2009) Sports injuries during the Summer Olympic Games 2008. American Journal of Sports Medicine, 37(11), 2165–2172
Vanhegan, I.S., Palmer-Green, D., Soligard, T., Steffen, K., O’Connor, P., Bethapudi, S., et al. (2013) The London 2012 summer Olympic games: An analysis of usage of the Olympic village “Polyclinic” by competing athletes. British Journal of Sports Medicine, 47(7), 415–419.
Engebretsen, L., Soligard, T., Steffen, K., Alonso, J. M., Aubry, M., Budgett, R., et al. (2013). Sports injuries and illnesses during the London Summer Olympic Games 2012. British Journal of Sports Medicine,47(7), 407–414.
Soligard, T., Steffen, K., Palmer, D., Alonso, J.M., Bahr, R., Lopes, A.D., et al. (2017) Sports injury and illness incidence in the Rio de Janeiro 2016 Olympic Summer. British Journal of Sports Medicine, 51(17), 1265–1271.
Junge, A., Dvořák, J. (2015). Football injuries during the 2014 FIFA World Cup. British Journal of Sports Medicine, 49(9), 599–602.
John, R., Dhillon, M. S., Syam, K., Prabhakar, S., Behera, P., & Singh, H. (2016). Epidemiological profile of sports-related knee injuries in northern India: An observational study at a tertiary care centre. Journal of Clinical Orthopaedics and Trauma,7(3), 207–211.
Nicolini, A. P., de Carvalho, R. T., Matsuda, M. M., Filho, J. S., & Cohen, M. (2014). Common injuries in athletes’ knee: Experience of a specialized center. Acta Ortopedica Brasileira,22(3), 127–131.
Baker, B. E., Peckham, A. C., Pupparo, F., & Sanborn, J. C. (1985). Review of meniscal injury and associated sports. The American Journal of Sports Medicine,13(1), 1–4.
Snoeker, B. A. M., Bakker, E. W. P., Kegel, C. A. T., & Lucas, C. (2013). Risk factors for meniscal tears: A systematic review including meta-analysis. Journal of Orthopaedic and Sports Physical Therapy,43(6), 352–367.
Church, S., & Keating, J. F. (2005). Reconstruction of the anterior cruciate ligament: timing of surgery and the incidence of meniscal tears and degenerative change. The Journal of bone and joint surgery British,87(12), 1639–1642.
Kaeding, C. C., Pedroza, A. D., Parker, R. D., Spindler, K. P., McCarty, E. C., & Andrish, J. T. (2005). Intra-articular findings in the reconstructed multiligament-injured knee. Arthroscopy: The Journal of Arthroscopic & Related Surgery,21(4), 424–430.
Naranje, S., Mittal, R., Nag, H., & Sharma, R. (2008). Arthroscopic and magnetic resonance imaging evaluation of meniscus lesions in the chronic anterior cruciate ligament-deficient knee. Arthroscopy: The Journal of Arthroscopic & Related Surgery,24(9), 1045–1051.
Yüksel, H. Y., Erkan, S., & Uzun, M. (2006). The evaluation of intraarticular lesions accompanying ACL ruptures in military personnel who elected not to restrict their daily activities: the effect of age and time from injury. Knee Surgery, Sports Traumatology, Arthroscopy,14(11), 1139–1147.
Gee, S. M., Tennent, D. J., Cameron, K. L., & Posner, M. A. (2020). The burden of meniscus injury in young and physically active populations. Clinics in Sports Medicine,39(1), 13–27.
Astur, D. C., Xerez, M., Rozas, J., Debieux, P. V., Franciozi, C. E., & Cohen, M. (2016). Anterior cruciate ligament and meniscal injuries in sports: incidence, time of practice until injury, and limitations caused after trauma. Revista Brasileria Ortopedia,51(6), 652–656.
Kompel, A.J., Murakami, A.M., Engebretsen, L., Forster, B.B., Lotfi, M., Jarraya, M., et al. (2018) MRI-detected sports-related knee injuries and abnormalities at the Rio de Janeiro 2016 summer Olympic Games. American Journal of Roentgenology, 211(4), 880–886.
Palacio, E.P., Candeloro, B.M., Lopes, A.A. (2009). Injuries in the professional soccer players of Marília Atlético Clube: A cohort study of the Brazilian Championship, 2003 to 2005. Revista Brasileira de Medicina do Esporte, 15(1), 31–35.
Baquie, P., & Brukner, P. (1997). Injuries presenting to an Australian sports medicine centre: a 12-month study. Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of,7(1), 28–31.
Arnason, A., Sigurdsson, S. B., Gudmundsson, A., Holme, I., Engebretsen, L., & Bahr, R. (2004). Risk factors for injuries in football. The American Journal of Sports Medicine,32(1 Suppl), 5S–16S.
Baquie, P., Brukner, P., Bradley, J., Honkamp, N. J., Jost, P., West, R., et al. (2018). Effect of anterior cruciate ligament reconstruction and meniscectomy on length of career in National Football League athletes: a case control study. Scandinavian Journal of Medicine & Science in sports,211(1), 880–886.
Bayne, H., Schwellnus, M., van Rensburg, D. J., Botha, J., & Pillay, L. (2018). Incidence of injury and illness in South African professional male soccer players: a prospective cohort study. Journal of Sports Medicine and Physical Fitness,58(6), 875–879.
Brophy, R. H., Gill, C. S., Lyman, S., Barnes, R. P., Rodeo, S. A., & Warren, R. F. (2009). Effect of anterior cruciate ligament reconstruction and meniscectomy on length of career in National Football League athletes: a case control study. American Journal of Sports Medicine,37(11), 2102–2107.
Brunner, M.C., Flower, S.P., Evancho, A.M., Allman, F.L., Apple, D.F., Fajman, W.A. (1989). MRI of the athletic knee. Findings in asymptomatic professional basketball and collegiate football players. Investigative Radiology, 24(1), 72–75.
Bradley, J., Honkamp, N. J., Jost, P., West, R., Norwig, J., & Kaplan, L. D. (2008). Incidence and variance of knee injuries in elite college football players. American Journal of Orthopedics (Belle Mead, NJ),37(6), 310–314.
Davies, M. A. M., Kerr, Z. Y., DeFreese, J. D., Arden, N. K., Marshall, S. W., Guskiewicz, K. M., et al. (2019). Prevalence of and risk factors for total hip and knee replacement in retired national football league athletes. American Journal of Sports Medicine,47(12), 2863–2870.
Loughran, G.J., Vulpis, C.T., Murphy, J.P., Weiner, D.A., Svoboda, S.J., Hinton, R.Y., et al. (2019) Incidence of knee injuries on artificial turf versus natural grass in National Collegiate Athletic Association American Football: 2004–2005 through 2013–2014 seasons. American Journal of Sports Medicine, 47(6), 1294–1301.
Mitchell, J., Graham, W., Best, T.M., Collins, C., Currie, D.W., Comstock, R.D., et al. . Epidemiology of meniscal injuries in US high school athletes between 2007 and 2013. Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA, 24(3), 715–722.
Stubbe, J.H., van Beijsterveldt, A.-M.M.C., van der Knaap, S., Stege, J., Verhagen, E.A., van Mechelen, W., et al. (2015) Injuries in professional male soccer players in the Netherlands: a prospective cohort study. Journal of Athletic Training, 50(2), 211–216.
Grim, C., Hotfiel, T., Engelhardt, M., Plewinski, S., Spahl, O., Wolfarth, B. (2017). Sports injuries and illnesses of the German National Team during the 2016 Sportverletzung Sportschaden. Organ der Gesellschaft fur, 31(1), 25–30.
Shalaj, I., Tishukaj, F., Bachl, N., Tschan, H., Wessner, B., & Csapo, R. (2016). Injuries in professional male football players in Kosovo: a descriptive epidemiological study. BMC Musculoskeletal Disorders,17(1), 338–338.
Khan, M. J., Khan, A. R., & Hawlader, M. D. H. (2019). The epidemiological profile of knee injury pattern among different divisional football player Turkish Journal of. Kinesiology,5(2), 50–56.
Hägglund, M., Waldén, M., Ekstrand, J. (2005). Injury incidence and distribution in elite football--a prospective study of the Danish and the Swedish top divisions. Scandinavian Journal of Medicine & Science in Sports, 15(1), 21–28.
Hawkins, R. D., & Fuller, C. W. (1999). A prospective epidemiological study of injuries in four English professional football clubs. British Journal of Sports Medicine,33(3), 196–203.
McGregor, J.C., Rae, A. (1995). A review of injuries to professional footballers in a premier football team (1990–1993). Scottish Medical Journal, 40(1), 16–18.
Hawkins, R. D., Hulse, M. A., Wilkinson, C., Hodson, A., & Gibson, M. (2001). The association football medical research programme: An audit of injuries in professional football. British Journal of Sports Medicine,35(1), 43–47.
Morgan, B. E., & Oberlander, M. A. (2001). An examination of injuries in major league soccer. The American Journal of Sports Medicine,29(4), 426–430.
Davis, J. M., & Bailey, S. P. (1997). Possible mechanisms of central nervous system fatigue during exercise. Medicine and Science in Sports and Exercise,29(1), 45–57.
Orchard, J. (2002). Is there a relationship between ground and climatic conditions and injuries in football? Sports Medicine (Auckland, NZ),32(7), 419–432.
Williams, S., Hume, P. A., & Kara, S. (2011). A review of football injuries on third and fourth generation artificial turfs compared with natural turf. Sports Medicine (Auckland, NZ),41(11), 903–923.
Horn, S., Gregory, P., & Guskiewicz, K. M. (2009). Self-reported anabolic-androgenic steroids use and musculoskeletal injuries: findings from the center for the study of retired athletes health survey of retired NFL players. American Journal of Physical Medicine and Rehabilitation,88(3), 192–200.
Hägglund, M., Waldén, M., & Ekstrand, J. (2006). Previous injury as a risk factor for injury in elite football: a prospective study over two consecutive seasons. British Journal of Sports Medicine,40(9), 767–772.
Larsen, E., Jensen, P. K., & Jensen, P. R. (1999). Long-term outcome of knee and ankle injuries in elite football. Scandinavian Journal of Medicine & Science in Sports,9(5), 285–289.
Roos, H. (1998). Increased risk of knee and hip arthrosis in elite level sports, but not in lower level exercise and sports. Lakartidningen, 95(42), 4606–4610.
Nawabi, D. H., Cro, S., Hamid, I. P., & Williams, A. (2014). Return to play after lateral meniscectomy compared with medial meniscectomy in elite professional soccer players. American Journal of Sports Medicine,42(9), 2193–2198.
Prien, A., Boudabous, S., Junge, A., Verhagen, E., Delattre, B.M.A., Tscholl, P.M. (2019). Every second retired elite female football player has MRI evidence of knee osteoarthritis before age 50 years: a cross-sectional study of clinical and MRI outcomes. Knee Surgery, Sports Traumatology, Arthroscopy.
Engström, B., Johansson, C., & Tornkvist, H. (1991). Soccer injuries among elite female players. The American Journal of Sports Medicine,19(4), 372–375.
Salzmann, G. M., Preiss, S., Zenobi-Wong, M., Harder, L. P., Maier, D., & Dvorák, J. (2017). Osteoarthritis in football: With a special focus on knee joint degeneration. Cartilage,8(2), 162–172.
Roth, T.S., Osbahr, D.C. (2018). Knee injuries in elite level soccer players. American Journal of Orthopedics (Belle Mead, NJ), 47(10). https://doi.org/10.12788/ajo.2018.0088.
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Concept: RV. Design: RV and SK. Intellectual content: RV, SK, and AV. Literature search: RV and SK. Data acquisition: RV and SK. Data analysis: RV, SK, and AV. Manuscript preparation: RV, SK, and AV. Manuscript editing: RV, SK, and AV. Manuscript critical review: RV, SK, and AV. Approval of manuscript: RV, SK, and AV.
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Vaishya, R., Kambhampati, S.B.S. & Vaish, A. Meniscal Injuries in the Olympic and Elite Athletes. JOIO 54, 281–293 (2020). https://doi.org/10.1007/s43465-020-00049-y
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DOI: https://doi.org/10.1007/s43465-020-00049-y