Table 3

Studies examining the effect of knee injury and/or alignment on the relationship between physical activity and risk for developing knee OA

Author (year)

Study design/participants

Measure(s) of OA

Measure(s) of physical activity

Results: effect of alignment/injury


Studies investigating self-reported symptomatic OA

Sutton et al. (2001) [20]

Retrospective case-control study/1,080 healthy participants

Self-reported, symptomatic

Self-reported; parameters not specified

Past history of knee injury was associated with increased risk for knee OA (OR 8.0, 95% CI 2.0 to 32.0)

Kujala et al. (1999) [19]

11-year cohort study/269 runners and 188 control individuals

Self-reported, symptomatic

Self-reported; MET index (intensity, duration and frequency); level of breathlessness

Runners reported knee OA more often than control individuals (OR 1.79, 95% CI 1.10 to 3.54 [P = 0.025])

The age-adjusted OR for having had knee ligament or meniscus injury was 1.62 (95% CI 0.99 to 2.65 [P = 0.055]) in runners compared with control individuals

Studies investigating self-reported physician diagnosed OA

Kujala et al. (1999) [19]

11-year cohort study/269 runners and 188 control individuals

Self-reported, physician diagnosed

Self-reported; MET index (intensity, duration and frequency); level of breathlessness

Runners reported knee OA more often than control individuals (OR 1.79, 95% CI 1.10 to 3.54 [P = 0.025]).

The age-adjusted OR for having had knee ligament or meniscus injury was 1.62 (95% CI 0.99 to 2.65 [P = 0.055]) in runners compared with control individuals

Radiographic studies investigating structural OA

Kujala et al. (1995) [15]

Retrospective cohort study/117 male former top-level athletes

Radiographic, structural; clinical

Self-reported; parameters not-specified

The risk of knee OA was increased in those with previous knee injuries (OR 4.73, 95% CI 1.32 to 17.0)

McDermott and Freyne (1983) [16]

Cross-sectional study/20 middle/long-distance runners

Radiographic, structural; clinical examination and arthroscopy

Self-reported; years of training/competition, training mileage

OA was reported in 6 of the 20 runners; athletes with degenerative changes had been running for a greater number of years (P < 0.05)

Participants with degenerative changes had greater incidence of genu varum and had experienced more knee injuries (P < 0.05)


BMI, body mass index; CI, confidence interval; MET, metabolic equivalent; OA, osteoarthritis; OR, odds ratio.

Urquhart et al. Arthritis Research & Therapy 2008 10:203   doi:10.1186/ar2343