Prevalence of knee osteoarthritis in former athletes: a systematic review with meta-analysis

Abstract

Background: Prevalence of knee osteoarthritis in former athletes is still unclear. Objective: To investigate prevalence of knee osteoarthritis in former athletes. Moreover, the secondary aim was to investigate whether poor methodological quality of included studies, different diagnosis criteria for knee osteoarthritis, different sports modality or sex impact on overall estimated prevalence of knee osteoarthritis in former athletes. Methods: Searches on MEDLINE, EMBASE, AMED, SPORTDiscus and CINAHL from the earliest record to February 2018 and hand-searching identified studies investigating prevalence of knee osteoarthritis in former athletes. Meta-analysis was conducted and the GRADE system summarized strength of the current recommendations. Sensitivity analyses investigated whether methodological quality, diagnostic criteria, type of sports or sex impacted on the overall estimated prevalence in former athletes. This review was registered at PROSPERO (CRD42016050903). Results: Fifteen studies were included and pooling of 3100 participants estimated overall prevalence of knee osteoarthritis in former athletes of 30.0% (95% CI: 20.0 to 40.0%). The strength of the current recommendations was low-quality. Sensitivity analyses suggested that different diagnostic criteria for knee osteoarthritis and type of sports may impact on the overall estimated prevalence. Conclusions: Prevalence of knee osteoarthritis in former athletes was 30.0%. Researchers, clinicians and policymakers should be careful about potential prevalence differences among type of sports and diagnostic criteria. Current low-quality evidence shows that future high-quality studies are likely to impact on the estimated prevalence.