A common question that the orthopaedic surgeon is asked by people who are intensely active in sport, and by long-distance runners in particular, is whether marathon running is a risk factor for early wear of the hip and knee. Long-distance runners subject their hips and knees to intense impact loading, and one would reasonably conclude that this is a predisposing factor for the development of osteoarthritis. The existing literature, however, appears to hold no evidence for anything of the kind.
A recent study published in the British journal “The Journal of Bone and Joint Surgery” set out to describe the health of the hip and knee in active marathon runners, taking into account the incidence of pain, arthritis, and the presence or absence of a joint replacement.
An international survey of marathon runners was carried out, and athletes were assessed who had completed more than 5 marathons and who train regularly, running at least 10 miles a week. The questionnaire included questions on pain, personal and family history of arthritis, history of any surgical procedures, running volume, personal marathon times and current level of sporting activity. The results were assessed by statistical methods.
In all, 675 people were assessed, of mean age 48 years (range 18 to 79), running a mean distance of 36 miles a week, for a mean period of 19 years (range 3 to 60), and having completed a mean of 76 marathons (range 5 to 1,016). Hip and knee pain was reported by 47% and arthritis by 8.9% of the marathon runners. Seven marathon runners went on running after hip or knee replacement surgery. Age and family history, and also a history of surgical procedures, were independent risk factors for arthritis. There was no significant risk associated with the duration of running, its intensity, the distance or the number of marathons completed.
The authors concluded that age, family history and a history of surgical procedures were independent factors by which the increased risk of hip and knee arthritis in active marathon runners can be predicted, although there was no association with running history. They also concluded that an across-the-board reassessment is needed in order to determine the effects of marathon running on the development of future arthritis in the hip and knee.
Source: “The Journal of Bone and Joint Surgery”, January 2018