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DOI: 10.1055/s-2004-818783
© Georg Thieme Verlag Stuttgart · New York
Führt Laufsport vorzeitig zu degenerativen Veränderungen am Hüftgelenk?
Ein systematischer ReviewIs Running Associated to Premature Degenerative Arthritis of the Hip?A Systematic ReviewA Systematic ReviewPublication History
Publication Date:
28 April 2004 (online)
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Zusammenfassung
Studienziel: Die Studie behandelt den Zusammenhang zwischen Laufsport und Arthrose des Hüftgelenks nach den Kriterien der evidenzbasierten Medizin. Methode: Die Datenbanken Medline, die Cochrane Library, das Zentrum für Evidence Based Medicine in Oxford, sowie die sportwissenschaftlichen Datenbanken Spolit, Spofor und Spowis wurden systematisch mit den Stichworten „arthritis, osteoarthritis, degenerative, hip, sports, running, jogging, walking” durchsucht. Ergebnisse: Es konnten 10 retrospektive Fallkontrollstudien und 3 prospektive Verlaufsbeobachtungsstudien in die Analyse einbezogen werden. Die prospektiven Studien ergaben im Bereich der klinischen Bewertung der Gelenke keine signifikanten Unterschiede zwischen Läufern und Nichtläufern. In einer Studie wurde isoliert bei Läufern unter 50 Jahre mit sehr hoher Laufbelastung ein leicht erhöhtes Arthroserisiko aufgrund des Röntgenbefundes beschrieben. In der Mehrzahl der retrospektiven Fallkontrollstudien konnte kein erhöhtes Arthroserisiko bei Läufern gefunden werden. In einigen der retrospektiven Untersuchungen wurde über ein leicht bis moderat erhöhtes Arthroserisiko berichtet. Der gemeinsame Schätzer der eingeschlossenen Studien ergab eine diskrete Erhöhung des Arthroserisikos für Läufer (gepoolte OR 1,24 95 % CI 0,87-1,85), wobei die Risikoerhöhung statistisch nicht signifikant ist. Die grafische Analyse der Daten mithilfe des Funnel Plots führt zu einer OR von 1,04. Schlussfolgerungen: Es besteht keine Evidenz, dass Laufsport zu einer Erhöhung des Arthroserisikos an der Hüfte führt. Ebenso besteht keine Evidenz für unterschiedliche Risiken bei Männern und Frauen.
Abstract
Aim: The study was performed to investigated correlations between running and degenerative arthritis of the hip, according to the principles of evidence-based medicine. Method: The database Medline, the Cochrane Library, the centre for Evidence Based Medicine in Oxford and the sports science database Spolit, Spofor and Spowis were scanned systematically for the keywords “arthritis, osteoarthritis, degenerative, hip, sports, running, jogging, walking”. Results: 10 retrospective case control studies and 3 prospective studies were included for further analysis. The clinical examinations reported in the prospective studies did not reveal a significant difference between runners and non-runners. In one study a slightly increased risk for signs of arthritis at the X-ray was found in runners below 50 years with a very high mileage. No increased risk for degenerative arthritis was reported in most of the retrospective studies. A few authors of retrospective studies reported a slightly to moderately increased risk. The pooled estimate of the included studies showed a slightly increased risk for degenerative arthritis in runners (pooled OR 1.24 95 % CI 0.87-1.85). However, the increased risk did not reach a level of statistical significance. The graphic analysis of the data with the technique of the funnel plot gives an OR of 1.04. Conclusion: There is no evidence that running is associated with an increased risk for degenerative arthritis of the hip. There is no evidence for a different risk in men and women.
Schlüsselwörter
Laufen - joggen - Sport - Hüfte - Arthrose
Key words
Running - jogging - sports - hip - arthritis
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PD Dr. med. Markus Walther
Lehrstuhl für Orthopädie der Universität Würzburg
König-Ludwig-Haus
Brettreichstraße 11
97074 Würzburg
Phone: +49 9 31/8 03 11 21
Fax: +49 9 31/8 03 11 29
Email: m-walther.klh@mail.uni-wuerzburg.de