Edinburgh Napier University

  Background: As the first step towards prevention of musculoskeletal disease among elite athletes, knowledge of epidemiology and modifiable risk factors is needed.

Aim: This study investigated the prevalence and risk factors associated with pain and osteoarthritis (OA) at the hip and knee in Great Britain’s (GB) Olympians aged 40 and older.

Methods: A cross-sectional study. A survey was distributed to 2742 GB Olympians living in 30 countries. Of the 714 who responded, 605 were eligible for the analysis (i.e. aged 40 and older).

Results: The prevalence of hip and knee pain was 22.4% and 26.1%, and hip and knee OA was 11.1% and 14.2%, respectively. Using a multivariable model, injury was detected to be associated with OA at the hip (aOR 10.85; 95% CI 3.80-30.96), and knee (aOR 4.92; 95% CI 2.58-9.38), and pain at the hip (aOR 5.55; 95% CI 1.83-16.86), and knee (aOR 2.65; 95% CI 1.57-4.46). Widespread pain was associated with pain at the hip (aOR 7.63; 95% CI 1.84-31.72), and knee (aOR 4.77; 95% CI 1.58-14.41). 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 risk factors associated with the onset and progression of OA / pain, and to determine if modulation of risk factors can reduce the prevalence of pain and OA in this population.