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Prevention and management of knee osteoarthritis and knee cartilage injury in sports
  1. Hideki Takeda1,2,
  2. Takumi Nakagawa2,
  3. Kozo Nakamura2,
  4. Lars Engebretsen1
  1. 1Oslo Sports Trauma Research Center, Oslo, Norway
  2. 2Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
  1. Correspondence to Dr Lars Engebretsen, Oslo Sports Trauma Research Center, Sognsveien 220, PB 4014 Ullevaal Stadion, 0806, Oslo, Norway; lars.engebretsen{at}


Articular cartilage defects in the knee of young or active individuals remain a problem in orthopaedic practice. These defects have limited ability to heal and may progress to osteoarthritis. The prevalence of knee osteoarthritis among athletes is higher than in the non-athletic population. The clinical symptoms of osteoarthritis are joint pain, limitation of range of motion and joint stiffness. The diagnosis of osteoarthritis is confirmed by the symptoms and the radiological findings (narrowing joint space, osteophyte formation and subchondral sclerosis). There is no strong correlation between symptoms and radiographic findings. The aetiology of knee osteoarthritis is multifactorial. Excessive musculoskeletal loading (at work or in sports), high body mass index, previous knee injury, female gender and muscle weakness are well-known risk factors. The high-level athlete with a major knee injury has a high incidence of knee osteoarthritis. Cartilage injuries are frequently observed in young and middle-aged active athletes. Often this injury precedes osteoarthritis. Reducing risk factors can decrease the prevalence of knee osteoarthritis. The prevention of knee injury, especially anterior cruciate ligament and meniscus injury in sports, is important to avoid progression of knee osteoarthritis.

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed