Abstract
Where risk factors have been identified in knee and hip osteoarthritis (OA), with few exceptions, no prevention strategies have proven beneficial. The major risk factors for knee OA are advanced age, injury and obesity. However, there is limited or no evidence that they are modifiable or to what degree modifying them is effective in preventing development of knee OA or in preventing symptoms and progressive disease in persons with early OA. The notable exception is the growing epidemic of (sports) injury related knee OA. This review details the biological and clinical data indicating the efficacy of interventions targeting neuromuscular and biomechanical factors that make this subset of OA an attractive public health target, and highlights research opportunities for the future.
Highlights
Osteoarthritis (OA) is the most important rheumatic disease affecting mankind
There is limited or no evidence that they are modifiable or to what degree modifying them is effective or what this would cost in primary prevention or secondary prevention
Lohmander and colleagues [2] estimate that the cumulative population risk of an anterior cruciate ligament (ACL) injury between 10 and 64 years of age is about 5% based on MRI findings of the acutely injured knee, and for meniscus injury leading to surgery is at least 15%
Summary
Osteoarthritis (OA) is the most important rheumatic disease affecting mankind. Where risk factors have been identified, such as in knee and hip OA, with few exceptions, no prevention strategies are well substantiated enough or have proven benefit to justify widespread dissemination. In the best studied sports injuries, even injury not precipitating a medical visit appears to be a risk factor for knee OA; the rate is high and increasing worldwide. Lohmander and colleagues [2] estimate that the cumulative population risk of an anterior cruciate ligament (ACL) injury between 10 and 64 years of age is about 5% based on MRI findings of the acutely injured knee, and for meniscus injury leading to surgery is at least 15%.
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