Long distance running and knee osteoarthritis. A prospective study

PainSci » bibliography » Chakravarty et al 2008
updated Nov 8, 2024

Tags: etiology, running, knee, patellar pain, counter-intuitive, good news, pro, exercise, self-treatment, treatment, leg, limbs, pain problems, arthritis, aging, overuse injury, injury

Three pages on PainSci cite Chakravarty 2008: 1. Guide to Repetitive Strain Injuries 2. Running does not wreck knees (probably) 3. Exercise is anti-inflammatory medicine for injuries (Member Post)

PainSci commentary on Chakravarty 2008: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

Chakravarty et al. tracked a few dozen older runners and non-runners for many years — most for more than a decade, some as long as twenty years — and 32% of the non-runners ended up with severe arthritis versus only 20% of the runners. And the runners started with 7%! And therefore…

“Severe OA may not be more common among runners.”

Indeed, it was clearly less common in this study.

This was a good quality prospective trial, which is exactly what this research question needed, but it was also tiny (among other acknowledged limitations). You might well see different results in another few dozen runners just by fluke.

“Much larger studies involving hundreds to thousands of healthy older adults followed for several decades are needed to determine if long-distance running may be associated with a modest decrease in incidence or severity of radiographic OA.”

~ Paul Ingraham

original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: Prior studies of the relationship of physical activity to osteoarthritis (OA) of the knee have shown mixed results. The objective of this study was to determine if differences in the progression of knee OA in middle- to older-aged runners exist when compared with healthy nonrunners over nearly 2 decades of serial radiographic observation.

METHODS: Forty-five long-distance runners and 53 controls with a mean age of 58 (range 50-72) years in 1984 were studied through 2002 with serial knee radiographs. Radiographic scores were two-reader averages for Total Knee Score (TKS) by modified Kellgren & Lawrence methods. TKS progression and the number of knees with severe OA were compared between runners and controls. Multivariate regression analyses were performed to assess the relationship between runner versus control status and radiographic outcomes using age, gender, BMI, education, and initial radiographic and disability scores among covariates.

RESULTS: Most subjects showed little initial radiographic OA (6.7% of runners and 0 controls); however, by the end of the study runners did not have more prevalent OA (20 vs 32%, p =0.25) nor more cases of severe OA (2.2% vs 9.4%, p=0.21) than did controls. Regression models found higher initial BMI, initial radiographic damage, and greater time from initial radiograph to be associated with worse radiographic OA at the final assessment; no significant associations were seen with gender, education, previous knee injury, or mean exercise time.

CONCLUSIONS: Long-distance running among healthy older individuals was not associated with accelerated radiographic OA. These data raise the possibility that severe OA may not be more common among runners.

original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

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