• J Athl Train · Jun 2017

    Osteoarthritis Prevalence in Retired National Football League Players With a History of Concussion and Lower Extremity Injury.

    • Robert C Lynall, Brian Pietrosimone, Zachary Y Kerr, Timothy C Mauntel, Jason P Mihalik, and Kevin M Guskiewicz.
    • Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center.
    • J Athl Train. 2017 Jun 2; 52 (6): 518-525.

    Context  Dynamic balance deficits have been described postconcussion, even after athletes return to play. Lower extremity (LE) musculoskeletal injury rates increase for up to 1 year after concussion, but the long-term musculoskeletal implications of concussion are unclear.Objective  To (1) examine the association of concussion and LE injury histories with osteoarthritis (OA) prevalence in retired National Football League players and (2) examine the association of concussion and LE injury histories with OA prevalence in those ≤55 years of age.Design  Case-control study.Setting  Survey.Patients Or Other Participants  We administered the Health Survey of Retired National Football League Players, which collects information about demographics, OA, LE injury, and concussion history.Main Outcome Measure(S)  Twelve discrete categories were created based on concussion and LE injury history, ranging from 0 concussions and 0 LE injuries (referent group) to 3+ concussions and 2+ LE injuries. Binomial regression analysis modeled lifetime OA prevalence. Covariates were body mass index, age at the time of the survey, and total years playing professional football.Results  Complete data were available for 2696 participants. Lifetime OA prevalence was smallest in the referent group (21.1%) and largest in the 3+ concussion and 2+ LE group (50.6%; 2.5 times the referent; 95% confidence interval [CI] = 2.1, 3.1). Participants in all concussion groups (1, 2, 3+) who reported a history of 0 LE injuries had a greater OA prevalence than the referent group. When participants were stratified by age, the ≤55 years of age, 3+ concussions, and 2+ LE injuries group prevalence ratio (3.6; 95% CI = 2.7, 5.2) was larger than that of the >55 years of age, 3+ concussions, and 2+ LE injuries group (1.8; 95% CI = 1.3, 2.4) compared with the respective referent groups.Conclusions  Concussion with or without a history of LE injury may be an important moderator of OA. Future researchers should seek to better understand the mechanisms that influence the association among concussion, LE injury, and OA.

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