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Table 3 Studies examining the effect of knee injury and/or alignment on the relationship between physical activity and risk for developing knee OA

From: Factors that may mediate the relationship between physical activity and the risk for developing knee osteoarthritis

Author (year) Study design/participants Measure(s) of OA Measure(s) of physical activity Results: effect of alignment/injury
Studies investigating self-reported symptomatic OA
   Sutton et al. (2001) [20] Retrospective case-control study/1,080 healthy participants Self-reported, symptomatic Self-reported; parameters not specified Past history of knee injury was associated with increased risk for knee OA (OR 8.0, 95% CI 2.0 to 32.0)
   Kujala et al. (1999) [19] 11-year cohort study/269 runners and 188 control individuals Self-reported, symptomatic Self-reported; MET index (intensity, duration and frequency); level of breathlessness Runners reported knee OA more often than control individuals (OR 1.79, 95% CI 1.10 to 3.54 [P = 0.025])
     The age-adjusted OR for having had knee ligament or meniscus injury was 1.62 (95% CI 0.99 to 2.65 [P = 0.055]) in runners compared with control individuals
Studies investigating self-reported physician diagnosed OA
   Kujala et al. (1999) [19] 11-year cohort study/269 runners and 188 control individuals Self-reported, physician diagnosed Self-reported; MET index (intensity, duration and frequency); level of breathlessness Runners reported knee OA more often than control individuals (OR 1.79, 95% CI 1.10 to 3.54 [P = 0.025]).
     The age-adjusted OR for having had knee ligament or meniscus injury was 1.62 (95% CI 0.99 to 2.65 [P = 0.055]) in runners compared with control individuals
Radiographic studies investigating structural OA
   Kujala et al. (1995) [15] Retrospective cohort study/117 male former top-level athletes Radiographic, structural; clinical Self-reported; parameters not-specified The risk of knee OA was increased in those with previous knee injuries (OR 4.73, 95% CI 1.32 to 17.0)
   McDermott and Freyne (1983) [16] Cross-sectional study/20 middle/long-distance runners Radiographic, structural; clinical examination and arthroscopy Self-reported; years of training/competition, training mileage OA was reported in 6 of the 20 runners; athletes with degenerative changes had been running for a greater number of years (P < 0.05)
     Participants with degenerative changes had greater incidence of genu varum and had experienced more knee injuries (P < 0.05)
  1. BMI, body mass index; CI, confidence interval; MET, metabolic equivalent; OA, osteoarthritis; OR, odds ratio.