Knee osteoarthritis and management of the retired athlete: the role of osteotomy

Abstract

Osteoarthritis (OA) of the knee is a common pathology in retired professional football players. Their lifetime risk of presenting with symptomatic OA with associated radiographic changes is higher than that of the general population. The increased risk of OA is predominantly associated with previous injury and repetitive microtrauma to the knee. Previous studies have also found an association between a higher prevalence of a varus phenotype and knee OA in this group of athletes. Despite this, the use of realignment osteotomy in this specific population has not been widely researched. An earlier realignment procedure, before the advent of severe radiographic disease, may be beneficial to optimize postoperative outcome, biological response to unloading, and subsequent knee survivorship. The purpose of this narrative review is to consider the role knee osteotomy can play in the treatment of OA in this specific patient population by discussing the biomechanical rationale behind it as well as the relevant literature.