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Osteoarthritis is the most common form of joint disease, sparing no
age, race, or geographic area. Symptomatic disease also increases with
age. This arthropathy is characterized by degeneration of cartilage and by
hypertrophy of bone at the articular margins. Inflammation is usually
minimal. Hereditary and mechanical factors may be variably involved in the
Degenerative joint disease is traditionall...
Degenerative joint disease is traditionally divided into two types:
(1) primary, which most commonly affects some or all of the following: the
terminal interphalangeal joints and less commonly the proximal
interphalangeal joints, the metacarpophalangeal and carpometacarpal joints
of the thumb, the hip, the knee, metatarsophalangeal joint of the big toe,
and the cervical and lumbar spine; and secondary, which may occur in any
joint as a sequela to articular injury resulting from either intra-
articular or extra-articular causes. The injury may be acute, as in a
fracture: chronic, that due to occupational overuse of a joint, metabolic
disease or neurologic disorders. Obesity is a risk factor for knee
osteoarthritis and probably for the hip as well. Recreational running does
not increase the incidence of osteoarthritis, but participation in
competitive contact sports does. Jobs requiring frequent bending and
carrying increase the risk of knee osteoarthritis.
Â Pathologically, the articular cartilage is first roughened and finally
worn away, and spur formation and lipping occur at the edge of the joint
surface. The synovial membrane becomes thickened and does not form
adhesions. Inflammation is prominent only in occasional patients. The
onset of the disease is insidious. Initially there is articular stiffness,
seldom lasting more than 15 minutes; this develops later into pain on
motion of the affected joint and is made worse by activity or weight
bearing and relieved by rest. There is no ankylosis, but limitation of
motion of the affected joint or joints is common. Joint effusion and other
articular signs of inflammation are mild.
As preventive measure, weight reduction has been shown in women to reduce
the risk of developing symptomatic knee osteoarthritis. Several
epidemiologic studies suggest that estrogen replacement therapy reduces
the risk of knee and hip osteoarthritis. For patients with mild to
moderate osteoarthritis of weight-bearing joints, a supervised walking
program may result in clinical improvement of functional status without
aggravating the joint pain. For many patients, acetaminophen in doses of
2.6-4 g/d is as effective as and less toxic than other NSAIDS. Patients
who fail to improve with acetaminophen and non-pharmacologic therapies
described above can be treated with salycilates or other NSAIDs.
Injury surveillance on young elite athletes participating in the 1st
Winter Youth Olympic Games in Innsbruck/Austria
Gerhard Ruedl (1), Wolfgang Schobersberger (2)
(1) Department of Sport Science, University Innsbruck/Austria
(2) Chief Medical Officer of Winter Youth Olympic Games in Innsbruck;
Institute for Sports Medicine, Alpine Medicine & Health Tourism
Do we really w...
Do we really want to see our young promising talents go through a
major injury at one stage into their career? Definitely no! However, in
competitive alpine skiing and snowboarding and freestyle, the risk to get
major head and anterior cruciate ligament injuries is indeed high [1-4].
Therefore, training focussing on injury prevention should already start at
early age and should go along with the athletes' career. To implement
evidence based preventive measures, however, it is of utmost importance to
investigate first of all data on occurrence and severity of injuries
according to the 4-step model of injury prevention research . At this
point of time, there is little data available concerning the injury risk
of youth elite athletes competing in winter sports [6, 7]. Therefore, we
will conduct a systematic injury and illness surveillance on young elite
athletes participating in the 1st Winter Youth Olympic Games in
Innsbruck/Austria in January 2012. Let us work together to get meaningful
data as a basis for further research on injury risk factors and injury
mechanisms and finally on injury prevention strategies among young elite
winter sport athletes. We are glad to welcome you in Innsbruck!
(1)Pujol N, Blanchi MP, Chambat P. The incidence of anterior cruciate
ligament injuries among competitive alpine skiers. Am J Sports Med 2007;
(2)Florenes TW, Bere T, Nordsletten L et al. Injuries among male and
female World Cup alpine skiers. Br J Sports Med 2009; 43: 973-8.
(3)Florenes TW, Nordsletten L, Heir S et al. Injuries among World Cup
freestyle skiers. Br J Sports Med 2010; 44: 803-8.
(4)Florenes TW, Nordsletten L, Heir S et al. Injuries among World Cup ski
and snowboard atlethes. Scand J Med Sci Sports. 2010 Jun 18 [Epub ahead of
(5)Bahr R, Krosshaug T. Understanding injury mechanisms: a key component
of preventing injuries in sport. Br J Sports Med 2005; 39: 324-9.
(6)Steffen K, Engebretsen L. The Youth Olympic Games and a new awakening
for sports and exercise medicine. Br J Sports Med 2011; 45: 1251-52.
(7)Steffen K, Engebretsen L. More data needed on injury risk among young
elite athletes. Br J Sports Med 2010; 44: 485-9.
The authors will conduct the injury and illness surveillance on young elite athletes participating in the 1st Winter Youth Olympic Games in Innsbruck/Austria in January 2012.