Knee Osteoarthritis in the Middle-Aged Former Athlete: Exercise Therapy Before, During and Instead of Surgery
DOI:
https://doi.org/10.5281/zenodo.22548962Keywords:
Knee osteoarthritis, Exercise therapy, Former athlete, Total knee arthroplasty, Post-traumatic osteoarthritis, ACL injuryAbstract
Former competitive athletes carry a substantially elevated lifetime risk of knee osteoarthritis, driven by a
combination of prior joint injury, repetitive high-load exposure, and, for some, earlier surgical
intervention. Structured exercise therapy has strong randomised trial and guideline support as a first-line
treatment for knee osteoarthritis in the general population, and a large randomised trial directly
comparing total knee arthroplasty against a structured nonsurgical programme found many patients
achieve comparable outcomes without surgery, yet referral patterns for the specific former-athlete
population remain inconsistently aligned with this evidence. This review synthesises the injury-risk,
exercise-therapy trial, and surgical-comparison literature relevant to knee osteoarthritis in the
middle-aged former athlete, with particular attention to the role structured exercise can play before,
during, and as an alternative to surgical management in this specific population.
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