Background Knowledge of the epidemiology and potentially modifiable factors associated with musculoskeletal disease is an important first step in injury prevention among elite athletes.
Aim This study investigated the prevalence and factors associated with pain and osteoarthritis (OA) at the hip and knee in Great Britain’s (GB) Olympians aged 40 and older.
Methods This is a cross-sectional study. A survey was distributed to 2742 GB Olympians living in 30 countries. Of the 714 (26.0%) who responded, 605 were eligible for analysis (ie, aged 40 and older).
Results The prevalence of hip and knee pain was 22.4% and 26.1%, and of hip and knee OA was 11.1% and 14.2%, respectively. Using a multivariable model, injury was associated with OA at the hip (adjusted OR (aOR) 10.85; 95% CI 3.80 to 30.96) and knee (aOR 4.92; 95% CI 2.58 to 9.38), and pain at the hip (aOR 5.55; 95% CI 1.83 to 16.86) and knee (aOR 2.65; 95% CI 1.57 to 4.46). Widespread pain was associated with pain at the hip (aOR 7.63; 95% CI 1.84 to 31.72) and knee (aOR 4.77; 95% CI 1.58 to 14.41). Older age, obesity, knee malalignment, comorbidities, hypermobility and weight-bearing exercise were associated with hip and knee OA and/or pain.
Conclusions This study detected an association between several factors and hip and knee pain/OA in retired GB Olympic athletes. These associations require further substantiation in retired athletes from other National Olympic Committees, and through comparison with the general population. Longitudinal follow-up is needed to investigate the factors associated with the onset and progression of OA/pain, and to determine if modulation of such factors can reduce the prevalence of pain and OA in this population.
- post olympic
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Contributors DJC conceived and designed the study, distributed the survey, collected, analysed and interpreted the data, and drafted the manuscript. BES assisted with the conception of the study and design. BES critically revised the manuscript and gave final approval of the version to be published. MEB assisted with the conception of the study and with accessing the study participants. MEB critically revised the manuscript and gave final approval of the version to be published. DP assisted with the conception of the study and with the distribution of the survey. DP critically revised the manuscript and gave final approval of the version to be published. All authors read and approved the final manuscript.
Funding This work was supported by Arthritis Research UK (grant number 20194), funding gratefully received from Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis.
Disclaimer The views expressed in the submitted article are those of the authors and not an official position of the institution or funder.
Competing interests None declared.
Patient consent Not required.
Ethics approval The Faculty of Medicine and Health Sciences Research Ethics Committee, The University of Nottingham (Ethics Reference No: K13022014). It was agreed in the ethics approval and with the British Olympic Association and the British Olympic Associations Athletes' Commission that implied consent would be used to avoid the use of personal signatures that could identify the GB Olympian. The letter of invitation and the participant information sheet made it explicit that by completing and returning the Olympian questionnaire, GB Olympians gave implied consent. GB Olympians were informed that if they completed and returned the Olympian questionnaire, they were consenting to have their details stored for future analysis. GB Olympians were informed that they were giving authorisation for inclusion of their data in public release data sets, such as journal articles and press releases.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement An anonymised summary of the data set generated and analysed during the current study may be available from the corresponding author on reasonable request.