A meta-analysis of observational research on the relationship between prior knee injuries and knee osteoarthritis

Background: Although knee injury has been linked to a higher chance of developing knee Osteoarthritis (OA), the amount of quantifiable risk varies greatly. Our goal was to thoroughly examine the connection between previous knee injuries and OA.

Methods: Between August and October 2010, six electronic databases were checked. The Odds Ratio (OR), 95% Confidence Intervals (CI), and relative risk estimates were taken from observational studies that met the inclusion criteria. Using the Egger’s test and the funnel plot, publication bias was identified. Utilising the Cochran Q test and I2 statistic, heterogeneity was investigated. The heterogeneous data were combined using a random effects model, and the results were then presented using an OR. In order to investigate potential sources of heterogeneity, subgroup analyses were carried out.

Results: The meta-analysis includes twenty-four observational studies (20,997 individuals), including seven cohort, five cross-sectional, and twelve case-control studies. A total pooled OR of 4.20 (95% CI 3.11-5.66, I2=81.0%) was calculated. For specified injuries, such as ligament or tendon injuries, meniscus damage or meniscectomy, and fractures of the femur, knee, or lower leg (OR=5.95, 95% 4.57-7.75), compared to unspecified injuries (OR=3.12, 95% 2.17-4.50), there was a significantly different association between history of knee injuries and knee OA.

Conclusion: Regardless of the study design or definition of a knee injury, a history of knee injuries is a significant risk factor for the development of knee OA. The future preventative programme for lowering the risk of knee OA should include knee injury as one of the few modifiable/preventable risk factors.