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

Abstract

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