Former male elite athletes have a higher prevalence of osteoarthritis and arthroplasty in the hip and knee than expected.

BACKGROUND Intense exercise has been reported as one risk factor for hip and knee osteoarthritis (OA). PURPOSE This study aimed to evaluate (1) whether this is true for both former impact and nonimpact athletes, (2) if the risk of a hip or knee arthroplasty due to OA is higher than expected, and (3) if joint deterioration is associated with knee injuries. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS The prevalence of OA and arthroplasty in the hip and knee were registered in 709 former male elite athletes with a median age of 70 years (range, 50-93 years), retired from sports for a median 35 years (range, 1-63 years), and compared with 1368 matched controls. Odds ratios (ORs) are presented as means with 95% confidence intervals (95% CIs). RESULTS The risk of hip or knee OA was higher in former athletes (OR, 1.9; 95% CI, 1.5-2.3), as was arthroplasty based on OA in either of these joints (OR, 2.2; 95% CI, 1.6-3.1). The risk of hip OA was doubled (OR, 2.0; 95% CI, 1.5-2.8) and hip arthroplasty was 2.5 times higher (OR, 2.5; 95% CI, 1.6-3.7) in former athletes than in controls, predominantly driven by a higher risk in former impact athletes. Also, the risk of knee OA was higher (OR, 1.6; 95% CI, 1.3-2.1), as was knee arthroplasty (OR, 1.6; 95% CI, 0.9-2.7), driven by a higher risk in both former impact and nonimpact athletes. Knee OA in impact athletes was associated with knee injury. CONCLUSION Hip and knee OA and hip and knee arthroplasty are more commonly found in former male elite athletes than expected. A previous knee injury is associated with knee OA in former impact athletes but not in nonimpact athletes.