Adolescence risk factors for meniscus and ligamentous knee injuries in adulthood: A longitudinal study

Abstract

<p><span>Purpose:</span><span> </span><span>Our aim is to investigate the in</span><span>fl</span><span>uence of adolescent health</span><span>‐</span><span>related</span><br><span>behaviours on the occurrence of meniscus and ligament injuries in a large</span><br><span>cohort of Finnish adolescents with an average 27</span><span>‐</span><span>year follow</span><span>‐</span><span>up.</span><br><span>Methods:</span><span> </span><span>The baseline data were surveys conducted biannually from 1981 to</span><br><span>1997, and these were individually linked to outcomes, as well as meniscus and</span><br><span>ligamentous knee injuries obtained from the Care Register for Health Care. A</span><br><span>total of 47,747 participants were included. Of these, 22,020 were male and</span><br><span>25,727 were female. A Cox regression model was used to analyze the asso-</span><br><span>ciations between exposure variables in adolescence (physical activity in sports</span><br><span>clubs, other physical activity, overweight, smoking, monthly drunkenness, pres-</span><br><span>ence of chronic disease, family socioeconomic status) and the risk for knee</span><br><span>injuries. Adjusted hazard ratios (aHR) with 95% con</span><span>fi</span><span>dence intervals (CIs) were</span><br><span>computed.</span><br><span>Results:</span><span> </span><span>The mean follow</span><span>‐</span><span>up time among the participants was 26.8 years</span><br><span>(standard deviation [SD]: 4.1 years). A total of 1163 (2.4%) persons su</span><span>ff</span><span>ered a</span><br><span>meniscus injury, and 1831 (3.8%) su</span><span>ff</span><span>ered a ligament injury. High physical</span><br><span>activity in sports clubs (aHR: 2.02, CI: 1.85</span><span>–</span><span>2.21), overweight (aHR: 1.37, CI:</span><br><span>1.12</span><span>–</span><span>1.68), monthly drunkenness (aHR: 1.37, CI: 1.19</span><span>–</span><span>1.57) and presence of</span><br><span>chronic disease (aHR 1.30, CI 1.08</span><span>–</span><span>1.56) increased the risk for meniscus inju-</span><br><span>ries. Similarly, high (aHR: 1.72, CI: 1.60</span><span>–</span><span>1.84) physical activity in sports clubs,</span><br><span>overweight (aHR: 1.26, CI 1.07</span><span>–</span><span>1.47), monthly drunkenness (aHR: 1.26, CI</span><br><span>1.13</span><span>–</span><span>1.41)</span><span> </span><span>and</span><span> </span><span>presence</span><span> </span><span>of</span><span> </span><span>chronic</span><span> </span><span>disease</span><span> </span><span>(aHR:</span><span> </span><span>1.36,</span><span> </span><span>CI:</span><span> </span><span>1.17</span><span>–</span><span>1.57)</span><br><span>increased the risk for ligament injuries.</span><br><span>Conclusions:</span><span> </span><span>Frequent physical activity in sports clubs presented a higher</span><br><span>risk for meniscus and knee ligament injuries in individuals under 40, com-</span><br><span>pared to degenerative factors such as being overweight or smoking. Inter-</span><br><span>ventions</span><span> </span><span>focusing</span><span> </span><span>on</span><span> </span><span>the</span><span> </span><span>suitable</span><span> </span><span>load</span><span> </span><span>level</span><span> </span><span>among</span><span> </span><span>adolescents</span><span> </span><span>with</span><br><span>frequent and high</span><span>‐</span><span>intensity physical activity, in addition to e</span><span>ff</span><span>orts to reduce</span><br><span>negative habits should be prioritized to lower the knee injury risk.</span><br></p>