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      Epidemiology of Posttraumatic Osteoarthritis

      , PhD, ATC , * , , PhD, LAT, ATC, FNATA * , , PhD, ATC, FACSM , , PhD, ATC

      Journal of Athletic Training

      National Athletic Trainers Association

      injuries, arthritis, knee, ankle

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          Abstract

          Osteoarthritis is a leading cause of disability whose prevalence and incidence continue to increase. History of joint injury represents an important risk factor for posttraumatic osteoarthritis and is a significant contributor to the rapidly growing percentage of the population with osteoarthritis. This review will present the epidemiology associated with posttraumatic osteoarthritis, with particular emphasis on the knee and ankle joints. It is important to understand the effect of posttraumatic osteoarthritis on the population so that sufficient resources can be devoted to countering the disease and promoting optimal long-term health for patients after joint injury.

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          Most cited references 51

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          The epidemiology of osteoarthritis.

          Osteoarthritis (OA) is a leading cause of disability and its incidence is rising due to increasing obesity and an ageing population. Risk factors can be divided into person-level factors, such as age, sex, obesity, genetics, race/ethnicity and diet, and joint-level factors including injury, malalignment and abnormal loading of the joints. The interaction of these risk factors is complex and provides a challenge to the managing physician. The purpose of this review is to illustrate how each of these factors interact together to instigate incident OA as well as to outline the need for ongoing epidemiologic studies for the future prevention of both incident and progressive OA. It is only by understanding the impact of this disease and the modifiable risk factors that we will be able to truly target public health prevention interventions appropriately.
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            Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005.

            The incidence of noncontact anterior cruciate ligament injuries in young to middle-aged athletes remains high. Despite early diagnosis and appropriate operative and nonoperative treatments, posttraumatic degenerative arthritis may develop. In a meeting in Atlanta, Georgia (January 2005), sponsored by the American Orthopaedic Society for Sports Medicine, a group of physicians, physical therapists, athletic trainers, biomechanists, epidemiologists, and other scientists interested in this area of research met to review current knowledge on risk factors associated with noncontact anterior cruciate ligament injuries, anterior cruciate ligament injury biomechanics, and existing anterior cruciate ligament prevention programs. This article reports on the presentations, discussions, and recommendations of this group.
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              Knee osteoarthritis after anterior cruciate ligament injury: a systematic review.

              This is a systematic review of studies on the prevalence of osteoarthritis in the tibiofemoral joint more than 10 years after an anterior cruciate ligament injury, the radiologic classification methods used, and risk factors for development of knee osteoarthritis. A systematic search was performed in PubMed, EMBASE, and AMED. Inclusion criteria were studies involving patients with anterior cruciate ligament injury, either isolated or combined with medial collateral ligament or meniscal injury and either surgically or nonsurgically treated, and a minimum 10-year follow-up with radiologic assessment. Methodological quality was evaluated using a modified version of the Coleman methodology score. Seven prospective and 24 retrospective studies were included. The mean modified Coleman methodology score was 52 of 90. Reported prevalence of knee osteoarthritis for subjects with isolated anterior cruciate ligament injury was between 0% and 13%. For subjects with anterior cruciate ligament and additional meniscal injury, the prevalence varied between 21% and 48%. Seven different radiologic classification systems were used in the studies. Only 3 studies reported reliability results for the radiologic assessments. The most frequently reported risk factor for development of knee osteoarthritis was meniscal injury. This systematic review suggests that the prevalence rates of knee osteoarthritis after anterior cruciate ligament reconstruction reported by previous reviews have been too high. The highest rated studies reported low prevalence of knee osteoarthritis for individuals with isolated anterior cruciate ligament injury (0%-13%) and a higher prevalence of knee osteoarthritis for subjects with combined injuries (21%-48%). Overall, the modified Coleman methodology score was low for the included studies. No universal methodological radiologic classification method exists, making comparisons of the studies and stating firm conclusions on the prevalence of knee osteoarthritis more than 10 years after anterior cruciate ligament injury difficult.
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                Author and article information

                Journal
                J Athl Train
                J Athl Train
                attr
                Journal of Athletic Training
                National Athletic Trainers Association
                1062-6050
                1938-162X
                June 2017
                : 52
                : 6
                : 491-496
                Affiliations
                [* ]Biodynamics Research Laboratory, University of North Carolina at Charlotte
                []Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
                []School of Kinesiology, University of Michigan, Ann Arbor
                Author notes
                Address correspondence to Abbey C. Thomas, PhD, ATC, Biodynamics Research Laboratory, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223. Address e-mail to afenwick@ 123456uncc.edu .
                Article
                PMC5488839 PMC5488839 5488839 attr-51-05-08 Customer Number: JAT0176-15R1
                10.4085/1062-6050-51.5.08
                5488839
                27145096
                © by the National Athletic Trainers' Association, Inc 2017
                Categories
                Literature Review

                knee, ankle, injuries, arthritis

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