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THE ROLE OF RUNNING IN THE DEVELOPMENT OF OSTEOARTHRITIS OF THE KNEE Alison Cheng
PURPOSE: With the growing number of individuals participating in exercise, concern has been raised about the possible long-term consequences of running on the musculoskeletal system. The purpose of this review was to determine whether running is a risk factor in the premature development of osteoarthritis (OA) of the knee. METHODS: A literature search was conducted on Medline and CINAHL databases (all files) using the keywords: osteoarthritis, knee, running, exercise, and risk factors. Additional studies were obtained from the reference lists of the original articles and background reviews. Only sufficiently detailed studies that investigated OA of the knees and used runners as subjects were reviewed. RESULTS: Ten articles were identified and accepted for review. Eight studies indicated that running does not lead to the accelerated development of OA of the knee. One study indicated that anatomical variances or previous joint injury might be a risk factor in the development of knee OA in runners. CONCLUSION: The preponderance of the reviewed studies to date, have not identified running as a definite causative factor in the premature occurrence of OA in the knees of runners. However, anatomic variances and prior joint injury may promote degenerative changes in some runners. More studies that investigate the role of these factors in the etiology of OA in runners is required. In addition, further studies using standardized definitions of clinical and radiographic OA, and involving sufficient samples of elite, recreational and non-runners in longitudinal studies are recommended. CLINICAL RELEVANCE: At-risk individuals must be identified by health professionals so that they can be educated about the possible deleterious effects associated with running and OA. The appropriate diagnosis, treatment and rehabilitation after injury, as well as proper education on conditioning, and the effects of fatigue may help protect knee joints from early degeneration.