To estimate the influence of long-term, high-intensity volleyball playing on premature
osteoarthritis (OA) of the ankle joint, we examined a group of 22 former elite volleyball-players
age (34±6 yrs.) who had played for at least 3 years in the highest volleyball league
in Switzerland, and 19 normal healthy untrained controls (35±6 yrs.). Volleyball-athletes
had played during an average of 5.5 (±2) h/wk for 8.5 (±3) yrs. Twenty of the 22 players
had suffered from at least one ankle sprain (average: 3.5), 10 had had ruptures of
the lateral ligaments (8 of them operated). Four players had severe mechanical instability,
5 a talar varus tilt in the stress X-ray of more than 8°. Subchondral sclerosis and
osteophytes were more prevalent in volleyballers than in controls (p< 0.001), while
the difference in joint space was not significant. No severe grades of OA could be
observed in these former elite volleyball players. Yet, a radiologic score of degenerative
ankle disease was elevated in 19/22 of them, but only in 2/19 controls (p < 0.001).
In multiple regression analysis among athletes, the anterior drawer sign and a feeling
of instability were the only significant and indepemdent predictors of an increased
radiological index (p = 0.003 and p = 0.02, respectively) from an initial set of 9
variables covering career length and intensity as volleyball player, clinical signs
of ankle instability and age. Even if in the present study, athletes had clearly more
radiologic findings than controls -such as spur formation and subchondral sclerosis-long-term,
high-intensity volleyball playing alone could not be confirmed as an independent risk
factor for OA of the ankle joint however, a combination of chronic lateral ankle instability
with intensive volleyball playing could marginally increase the risk of ankle OA.
Key words
Ankle joint - degenerative joint disease - physical activity - exercise - volleyball
- osteoarthritis.
