Bone Quality in Competitive Athletes: A Systematic Review

Area of Science:

• Sports Medicine
• Orthopedics
• Bone Physiology

Background:

• Competitive athletes undergo rigorous training, potentially impacting bone health.
• High-resolution peripheral quantitative computed tomography (HR-pQCT) is a key imaging technique for assessing bone microarchitecture.
• Understanding bone quality in athletes is crucial for injury prevention and performance optimization.

Approach:

• A systematic literature review was conducted using Medline, EMBASE, and Sport Discus databases up to January 2023.
• Included studies focused on competitive athletes (aged 14-45) assessed with HR-pQCT.
• Data extracted included study design, imaging details, bone variables, and athlete/sport information.

Key Points:

• The review analyzed 14 manuscripts involving 928 individuals, with 78% being athletes (93% female).
• Athletes were categorized into healthy, those with menstrual dysfunction (amenorrhea), and those with bone stress injuries.
• Healthy athletes demonstrated significantly better bone quality (density, strength, microarchitecture) via HR-pQCT compared to controls.

Conclusions:

• HR-pQCT reveals that healthy competitive athletes possess enhanced bone quality.
• Athletes experiencing amenorrhea or bone stress injuries do not show these bone quality benefits, indicating compromised skeletal health.
• These findings highlight the importance of monitoring bone health in specific athletic populations.