Risk of degenerative ankle joint disease in volleyball players: Study of former elite athletes

To estimate the influence of long-term, high-intensity volleyball playing o n 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 a t least 3 years in the highest volleyball league in Switzerland, and 19 nor mal healthy untrained controls (35 +/- 6 yrs.). Volleyball-athletes had pla yed 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 player s had severe mechanical instability, 5 a talar varus tilt in the stress X-r ay of more than 8. Subchondral sclerosis and osteophytes were more prevalen t in volleyballers than in controls (p<0.001), while the difference in join t space was not significant. No severe grades of OA could be observed in th ese former elite volleyball players. Yet, a radiologic score of degenerativ e 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 drawe r sign and a feeling of instability were the only significant and independe nt predictors of an increased radiological index (p=0.003 and p=0.02, respe ctively) from an initial set of 9 variables covering career length and inte nsity as volleyball player, clinical signs of ankle instability and age. Ev en if in the present study, athletes had clearly more radiologic findings t han controls-such as spur formation and subchondral sclerosis- long-term, h igh-intensity volleyball playing alone could not be confirmed as an indepen dent risk factor for OA of the ankle joint however, a combination of chroni c lateral ankle instability with intensive volleyball playing could margina lly increase the risk of ankle OA.