Does running increase the risk of knee osteoarthritis (OA)? To answer this question, a team of researchers from the United States conducted a systematic review of 17 studies in the PubMed, Embase and the Cochrane Library databases that examined the effect of running on knee OA determined by patient-reported outcomes (assessed by the complaint of knee pain, Health Assessment Questionnaire-Disability Index and the Knee injury and Osteoarthritis Outcome Score) or imaging (plain x-rays and MRI scans).¹ Together they involved 7194 runners (mean age 56.2 years) and 6947 nonrunners (mean age 61.6 years).

Nonrunner participants complained of knee pain more than the runner group. No significant differences were observed between the two groups regarding radiographic knee OA (based on tibiofemoral / patellofemoral joint-space narrowing or Kellgren-Lawrence grade) or cartilage thickness on MRI in several studies, though in one study, osteophytes in the tibiofemoral and patellofemoral joints were seen in larger number among runners. And, in one study, nonrunners had a significantly higher risk of knee OA which progressively advanced to total knee replacement (TKR) vs runners; 4.6% vs 2.6%, respectively.

These findings published in the Orthopaedic Journal of Sports Medicine show a higher prevalence of knee pain among nonrunners compare to runners. The odds of undergoing a TKR were also higher among nonrunners suggesting that moderate-distance running did not worsen the patient-reported outcomes or radiological evidence of knee OA.

Reference

1. Dhillon J, et al. Effects of running on the development of knee osteoarthritis: an updated systematic review at short-term follow-up. Orthop J Sports Med. 2023 Mar 1;11(3):23259671231152900. doi: 10.1177/23259671231152900.