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Osteoarthritis and the Middle Aged Athlete: The Present and Future

Maffulli, Nicola MD, MS, PhD, FRCP, FRCS(Orth)*,†,‡

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Sports Medicine and Arthroscopy Review: June 2022 - Volume 30 - Issue 2 - p 77
doi: 10.1097/JSA.0000000000000348
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Osteoarthritis (OA) is prevalent, troublesome, impacts negatively on the quality of life, impairing participation to sport and recreational activities. OA is a most common musculoskeletal condition globally, affecting up to 20% of individuals over 60 in the Western world. We live in a society where sports participation and physical exercise have become part of the mantra of healthy living. Many of us wish to continue to stay active, and even undertake competitive sport at ripe old age: it is still controversial whether sport participation is a risk factor for OA development or progression. Mechanical overload, injuries, genetics, and acquired disorders concur to the onset of OA, with high variability between sports and participants. Sport participation protects against major metabolic health problems, including cardiovascular disease, osteoporosis, and diabetes. Repetitive impact and loading, joint overuse, and recurrent injuries followed by a too rapid return to sport might explain the predisposition of athletes to joint degeneration, with sport and recreational activities identified as risk factors for knee OA: such risk correlates with the intensity and duration of exposure.

This issue of Sports Medicine and Arthroscopic Review examines the available evidence in this field. It is never easy to collate and analyse the large available scientific literature, and answers are often not univocal. We have collected systematic reviews in the area of OA and sport, and perhaps some answers can be given. The old adage that too much is never too good seems to emerge, but unfortunately, as one of my mentors, Lyle Micheli MD, used to say “We only understand how much was enough by learning how much was too much.”

On the Cover:

Lipoaspiration being performed from abdominal adipose tissue. Sports Med Arthrosc Rev. 2022;30:e9–e16.

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