Risk of knee osteoarthritis after different types of knee injuries in young adults: a population-based cohort study. Issue 12 (11th December 2019)

• Record Type: Journal Article
• Authors: Snoeker, Barbara; Turkiewicz, Aleksandra; Magnusson, Karin; Frobell, Richard; Yu, Dahai; Peat, George; Englund, Martin
• Is Part Of: British journal of sports medicine. Volume 54:Issue 12(2020)
• Page Start: 725
• Page End: 730
• Publication Date: 2019-12-11
• Subjects: knee injuries -- knee ACL -- meniscus -- fracture -- osteoarthritis; Sports medicine -- Periodicals; 617.1027
• DOI: 10.1136/bjsports-2019-100959
• Languages: English
• ISSNs: 0306-3674

Abstract

Abstract : Objectives: To estimate the risk of clinically diagnosed knee osteoarthritis (OA) after different types of knee injuries in young adults. Methods: In a longitudinal cohort study based on population-based healthcare data from Skåne, Sweden, we included all persons aged 25–34 years in 1998–2007 (n=149 288) with and without diagnoses of knee injuries according to International Classification of Diseases (ICD)-10. We estimated the HR of future diagnosed knee OA in injured and uninjured persons using Cox regression, adjusted for potential confounders. We also explored the impact of type of injury (contusion, fracture, dislocation, meniscal tear, cartilage tear/other injury, collateral ligament tear, cruciate ligament tear and injury to multiple structures) on diagnosed knee OA risk. Results: We identified 5247 persons (mean (SD) age 29.4 (2.9) years, 67% men) with a knee injury and 142 825 persons (mean (SD) age 30.2 (3.0) years, 45% men) without. We found an adjusted HR of 5.7 (95% CI 5.0 to 6.6) for diagnosed knee OA in injured compared with uninjured persons during the first 11 years of follow-up and 3.4 (95% CI 2.9 to 4.0) during the following 8 years. The corresponding risk difference (RD) after 19 years of follow-up was 8.1% (95% CI 6.7% to 9.4%). Cruciate ligament injury, meniscal tear and fracture of the tibia plateau/patella were associated with greatest increase in risk (RD of 19.6% (95% CI 13.2% to 25.9%), 10.5% (95% CI 6.4% to 14.7%) and 6.6% (95% CI 1.1% to 12.2%), respectively). Conclusion: In young adults, knee injury increases the risk of future diagnosed knee OA about sixfold with highest risks found after cruciate ligament injury, meniscal tear and intra-articular fracture.