@article{290685bda314442d941b074f927794be,
title = "Football Increases Future Risk of Symptomatic Radiographic Knee Osteoarthritis",
abstract = "Introduction Male youth in the United States commonly participate in gridiron (American) football. There are little data substantiating current popular opinion that it is associated with knee pain or osteoarthritis (OA) later in life. We aimed to evaluate the relationship of football with these outcomes in the Osteoarthritis Initiative (OAI). Methods This is a study of male OAI participants with knee x-ray readings, symptom assessments, and completed surveys on lifetime physical activity. The OAI is a multicenter, observational cohort recruited from the community not based on football participation status. A history of exposure to American football was ascertained via self-report. Knee radiographs were scored for Kellgren-Lawrence grade (0-4). Radiographic OA (ROA) was defined as Kellgren-Lawrence ≥ 2 in at least one knee. Frequent knee pain meant at least one knee with frequent knee pain. Symptomatic ROA required at least one knee with both ROA and frequent knee pain. Results A total of 1166 men had a mean age of 63.7 (SD, 9.2) yr and body mass index of 28.6 (SD, 4.2) kg·m-2. Thirty-one percent (365/1166) played football at some point in their lives, 95% of whom participated from ages 12 to 18 yr. The ORs for symptomatic ROA from the lowest to highest football participation were 1.2, 1.5, and 2.2, respectively (P for trend = 0.004). Findings were similar for football from ages 12 to 18 yr and for outcomes of knee pain and ROA. Conclusion This is the first large epidemiologic study to suggest that football participation, including in the teen years, may be detrimental toward knee health. Prospective studies evaluating football players are warranted.",
keywords = "Football (American), knee, knee pain, osteoarthritis",
author = "Lo, {Grace H.} and McAlindon, {Timothy E.} and Kriska, {Andrea M.} and Price, {Lori Lyn} and Rockette-Wagner, {Bonny J.} and Mandl, {Lisa A.} and Eaton, {Charles B.} and Hochberg, {Marc C.} and Jackson, {Rebecca D.} and Kwoh, {C. Kent} and Nevitt, {Michael C.} and Driban, {Jeffrey B.}",
note = "Funding Information: Dr. Lo is supported by K23 AR062127, a National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases funded mentored award, providing support for design and conduct of the study, analysis, and interpretation of the data. This work is supported in part with resources at the VA HSR D Center for Innovations in Quality, Effectiveness and Safety (No. CIN 13-413), at the Michael E. DeBakey VA Medical Center, Houston, TX. The OAI is a public private partnership that comprised five contracts (N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript has received the approval of the Osteoarthritis Initiative Publications Committee based on a review of its scientific content and data interpretation. Funding Information: Dr. Lo is supported by K23 AR062127, a National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases–funded mentored award, providing support for design and conduct of the study, analysis, and interpretation of the data. This work is supported in part with resources at the VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (No. CIN 13-413), at the Michael E. DeBakey VA Medical Center, Houston, TX. The OAI is a public–private partnership that comprised five contracts (N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript has received the approval of the Osteoarthritis Initiative Publications Committee based on a review of its scientific content and data interpretation. Publisher Copyright: {\textcopyright} 2019 Lippincott Williams & Wilkins.",
year = "2020",
month = apr,
day = "1",
doi = "10.1249/MSS.0000000000002189",
language = "English (US)",
volume = "52",
pages = "795--800",
journal = "Medicine and Science in Sports and Exercise",
issn = "0195-9131",
publisher = "Lippincott Williams and Wilkins",
number = "4",
}