NEW YORK (Reuters Health) - Some knee injuries appear to cause years of pain and increase the risk of arthritis among female soccer players, a new study shows.

Among women who experienced an anterior cruciate ligament (ACL) injury 12 years earlier, more than half had developed osteoarthritis in the knee, and three-quarters said symptoms from their injuries continued to interfere with their quality of life.

On average, the women were only 31 years old, making them "young women with knees of old women," study author Dr. L. Stefan Lohmander told Reuters Health.

When playing soccer, women are more at risk of knee injuries than men, and there's a need to implement training programs that prevent ACL injuries and "focus on the needs of female athletes," said Lohmander, who is based at the University Hospital in Lund, Sweden.

Currently, 7 million women participate in organized soccer in the U.S. alone. In Sweden, women's soccer is the second largest sport in the country.

Statistics show that women are up to 4 times more likely than men to suffer ACL tears while playing soccer. Women also tend to develop knee injuries an average of 4 years before men, Lohmander and his colleagues note in the journal Arthritis & Rheumatism.

Lohmander explained that women may be more at risk of knee problems than men because of a variety of factors, such as hormones, different styles of jumping during sports, and a different balance between muscle and knee ligament strength. "But the answer is, we don't really know," the researcher said.

To investigate the long-term consequences of knee injuries for women, the researchers asked 103 female soccer players about the ACL injuries they sustained 12 years earlier.

The investigators found that more than 60 percent of the study participants had undergone reconstructive surgery to try to repair the ACL. Despite that, 51 percent of women developed osteoarthritis in their knees, and 42 percent experienced pain related to arthritis.

Overall, three-quarters of women said their knee injuries had affected their quality of life.

Lohmander added that ACL injuries are one of the most serious types of knee injuries, and they are extremely common in sports featuring running mixed with pivoting, twisting and a sudden change of direction. "Soccer, basketball, and European handball are good examples," the researcher noted.

SOURCE: Arthritis & Rheumatism, October 2004.

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