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Therapeutic Exercise and Conservative Injection Treatment for Early Knee Osteoarthritis in Athletes: A Scoping Review

1
Department of Neurosciences, Physical Medicine and Rehabilitation School, University of Padua, 35128 Padua, Italy
2
Neurorehabilitation and Spinal Unit, Institute of Bari, Istituti Clinici Scientifici Maugeri IRCCS, 70124 Bari, Italy
3
Rheumatology Unit, Department of Medicine-DIMED, University of Padua, 35128 Padua, Italy
4
Department of Clinical and Experimental Medicine, Physical Medicine and Rehabilitation School, University of Foggia, 71122 Foggia, Italy
*
Author to whom correspondence should be addressed.
Academic Editors: Giovanni Iolascon and Umberto Tarantino
Medicina 2022, 58(1), 69; https://doi.org/10.3390/medicina58010069
Received: 9 December 2021 / Revised: 30 December 2021 / Accepted: 30 December 2021 / Published: 3 January 2022
(This article belongs to the Special Issue Challenges and Solutions for Musculoskeletal Disorders in Athletes)
Background and Objectives: Recent evidence highlighted a higher prevalence of knee osteoarthritis (kOA) among young and former ex-professional athletes. Although the practice of a highly demanding sport is considered a predisposing factor for the knee joint cartilage degeneration, articular cartilage seems to positively respond to a moderate load increase. We aim to investigate recent evidence on the conservative management of early kOA in athletes, with a particular emphasis on therapeutic exercise and injection treatment, in order to highlight whether there are any indications that can influence clinical and rehabilitation practice. Materials and Methods: A scoping review was conducted, screening MEDLINE and PEDro databases for studies published over the past twenty years on the topic. Studies in English, with accessible abstracts, were included in the review. The PICO framework was used (P—patient: athletes, I—Intervention: conservative treatment with therapeutic exercise or injection therapies, C—Comparison: not needed, O—Outcomes: clinical outcomes). Clinical trials, randomized controlled trials, and longitudinal studies were considered. Results: Four studies were finally included in the review. Therapeutic exercise seems to have beneficial effects on prevention of cartilage degeneration, on pain reduction, and on physical function enhancement. On the other hand, in mild to moderate stages of kOA the intra-articular viscosupplementation with Hyaluronic Acid showed a medium to long-term improvement in joint pain and function. The Platelet Rich Plasma treatment also showed a significant improvement in pain and function up to 12 months. Conclusions: Despite the heterogeneity of the studies considered, a multimodal treatment combining therapeutic exercise and moderate aerobic activity (such as running) should be indicated to prevent kOA development. In cases of symptomatic kOA it may be indicated to add minimally invasive injection therapy that seems to contribute to the improvement of motor function and symptomatology. View Full-Text
Keywords: sport; professional athletes; early osteoarthritis; therapeutic exercise; physical activity sport; professional athletes; early osteoarthritis; therapeutic exercise; physical activity
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MDPI and ACS Style

Tognolo, L.; Maccarone, M.C.; De Trane, S.; Scanu, A.; Masiero, S.; Fiore, P. Therapeutic Exercise and Conservative Injection Treatment for Early Knee Osteoarthritis in Athletes: A Scoping Review. Medicina 2022, 58, 69. https://doi.org/10.3390/medicina58010069

AMA Style

Tognolo L, Maccarone MC, De Trane S, Scanu A, Masiero S, Fiore P. Therapeutic Exercise and Conservative Injection Treatment for Early Knee Osteoarthritis in Athletes: A Scoping Review. Medicina. 2022; 58(1):69. https://doi.org/10.3390/medicina58010069

Chicago/Turabian Style

Tognolo, Lucrezia, Maria C. Maccarone, Stefania De Trane, Anna Scanu, Stefano Masiero, and Pietro Fiore. 2022. "Therapeutic Exercise and Conservative Injection Treatment for Early Knee Osteoarthritis in Athletes: A Scoping Review" Medicina 58, no. 1: 69. https://doi.org/10.3390/medicina58010069

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