Pro Footballers Have Increased Risk of Total Knee Replacement

Recent research from the University of Nottingham has confirmed that retired professional footballers are far more prone to develop knee pain and osteoarthritis and face problems with their knees earlier in life than the average person, with increased rate of total knee replacement surgery performed at some point.

The research was led by Dr Gwen Fernandes and Professor Michael Doherty from the Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, and was funded by Arthritis Research UK with from FMARC (FIFA’s Medical and Research Centre) the Professional Footballers Association and the SPIRE Healthcare Group. Their conclusion: male ex-pros were two to three times more likely to suffer from knee pain and knee osteoarthritis and require a total knee replacement – even after adjustment for other risk factors including significant knee injury.

The pain of retirement

Furthermore, the study – published in the British Journal of Sports Medicine – reported that ex-footballers reported more knee pain, structural knee osteoarthritis on x-ray and total knee replacement surgery across all age groups in the study – and especially in younger age groups, such as the 40-54 age group. It wasn’t all doom and gloom, however: the research also revealed that although former footballers presented with more musculoskeletal pain, they were less likely to suffer with and report other conditions or diseases such as diabetes, heart attacks and cancer.

The study – one of the largest and most comprehensive of its kind – recruited over 1,200 ex-footballers with an average age of 59 years, recruited via the PFA and from individual league clubs and professional football associations in the UK. Their data was cross-referenced with that of over 4,000 men from the East Midlands with an average age of 62.8 years, and as well as the main findings, the date threw up all manner of strange conclusions, such as;

Ex-footballers had more osteoarthritis in the end joints of their fingers (nodal OA)
Ex-footballers were more likely to have an index finger shorter than their ring finger — also known as a pattern three-digit ratio, which has been previously linked to osteoarthritis risk
Ex-footballers reported significantly more body pain, knee misalignment and use of painkillers than the study group from the general population

‘Repetitive Microtrauma’ singled out for blame

Why would playing professional football cause such an increased risk of osteoarthritis? The study flags up the ‘repetitive microtrauma’ that the sport imposes on its participants, and has identified it as the most likely main cause. And although the health benefits of professional sport are obvious, so is the concern for the welfare of players after their careers are over.

As the FA, PFA, the Premier League and English Football League announced in a joint statement: “We welcome Arthritis Research UK’s study into cases of ex-professional footballers affected by osteoarthritis and have collectively and collaboratively supported them in this research. Although there are multiple health benefits from playing football, we are also aware of the risks of intensive and prolonged training and playing at professional level.

“We understand that there are far-reaching and wider benefits of playing football, including overall quality of life and physical and mental well-being. However, it is important that we continue to support ex-professional players with the condition and use this new research to form practical guidance for current professional footballers and clubs to help minimise the risk of developing osteoarthritis.”