Surreal illustration of a young athlete's knee transitioning into an arthritic joint, symbolizing the long-term impact of sports injuries.

Knee Injuries in Young Athletes: Can a Simple Blood Test Predict Future Arthritis?

Beau Callahan in Health & Wellness November 2025 • 5 min read.

"New research explores how early detection of cartilage damage could revolutionize sports injury management and long-term joint health."

Sports injuries are a common rite of passage for many young athletes. While some injuries heal completely, others can have long-lasting consequences, significantly increasing the risk of developing osteoarthritis (OA) later in life. This is particularly concerning because OA, traditionally considered an age-related condition, is increasingly affecting younger, active individuals.

Knee injuries, in particular, are a major culprit. In Canada, sports participation is the leading cause of injury in youth, with knee and ankle injuries accounting for over 40% of the burden. Studies show a tenfold increased risk of knee OA within 12-20 years after the initial injury. This has led researchers to investigate ways to identify high-risk individuals early on so that preventative measures can be taken.

One promising area of research focuses on biomarkers, measurable substances in the body that can indicate a disease state or condition. Cartilage oligomeric matrix protein (COMP) is one such biomarker. COMP is a structural protein vital for healthy cartilage function, and elevated levels of COMP in the blood have been linked to cartilage degradation. Recent studies are exploring whether COMP can serve as an early warning sign for OA development in young athletes with a history of knee injuries.

COMP: A Cartilage Health Barometer for Young Athletes?

Surreal illustration of a young athlete's knee transitioning into an arthritic joint, symbolizing the long-term impact of sports injuries.

Researchers at the University of Calgary and the University of Alberta investigated the potential of COMP as a predictive biomarker for OA in young athletes. The study, published in Osteoarthritis and Cartilage, focused on individuals aged 16-26 who had sustained a sport-related intra-articular knee injury 3-10 years prior. The researchers compared these individuals to a control group of uninjured, matched participants.

The study involved a comprehensive analysis of serum COMP levels, COMP fragmentation patterns, and clinical outcomes using MRI Osteoarthritis Knee Scores (MOAKS) and Knee Osteoarthritis Outcome Scores (KOOS). Participants also underwent body composition analysis to measure fat mass index (FMI). The goal was to determine if there was a correlation between COMP levels, injury history, and early signs of OA.

Study Design: Included 170 participants, with 85 having a 3-10 year history of knee injury and 85 controls.
Measurements: Serum COMP levels, fragmentation patterns, MOAKS, KOOS, and FMI were analyzed.
Key Finding: Injured males initially showed ~15% higher COMP levels, but this difference disappeared after adjusting for FMI.
Fragmentation Patterns: Unique COMP fragmentation patterns were observed in injured versus uninjured individuals.

The results revealed interesting insights. While there was no overall difference in COMP levels between injured and uninjured females, injured males initially showed approximately 15% greater COMP levels than their uninjured counterparts. However, this difference vanished after accounting for FMI, suggesting that body composition plays a significant role. Importantly, the study also found distinct COMP fragmentation patterns between injured and uninjured individuals, indicating that the way COMP breaks down might be a more sensitive indicator of joint damage than the total COMP level alone. Furthermore, in injured participants, COMP levels were associated with MOAKS synovitis scores and FMI, highlighting the complex interplay between inflammation, body composition, and cartilage health.

The Future of Injury Prevention: Personalised Approaches to Joint Health

This research underscores the importance of early detection and personalized prevention strategies for young athletes at risk of developing OA. While COMP levels alone may not be a definitive predictor, the study suggests that COMP fragmentation patterns, in conjunction with other factors like body composition and MRI findings, could provide a more comprehensive assessment of joint health. Future research should focus on further elucidating the role of COMP fragmentation and identifying other potential biomarkers that can help predict and prevent the long-term consequences of sports-related knee injuries.

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Everything You Need To Know

What is Cartilage Oligomeric Matrix Protein (COMP), and how is it relevant to knee injuries in young athletes?

Cartilage oligomeric matrix protein, or COMP, is a structural protein essential for healthy cartilage. Elevated levels of COMP in the blood may indicate cartilage is breaking down. The study suggests that COMP levels are not a definitive predictor alone, COMP fragmentation patterns, along with factors like body composition and MRI findings, could offer a more comprehensive assessment. Further research could look into COMP fragmentation and other biomarkers to better predict long-term effects of knee injuries.

What was the main goal of the study conducted by the University of Calgary and the University of Alberta regarding knee injuries in young athletes?

The research explored the link between sport-related knee injuries in young athletes and the development of osteoarthritis later in life, focusing on identifying early warning signs using biomarkers like Cartilage Oligomeric Matrix Protein, COMP. The study, conducted at the Universities of Calgary and Alberta, examined COMP levels and fragmentation patterns in athletes aged 16-26 who had experienced knee injuries. The goal was to find correlations between COMP, injury history, and early indicators of osteoarthritis. Body composition, measured as fat mass index (FMI), was also taken into consideration.

What were the key findings of the study regarding COMP levels and fragmentation patterns in young athletes with knee injuries?

The study revealed that injured males initially had about 15% higher COMP levels than uninjured males; this difference disappeared after considering fat mass index, FMI, which indicates the important role of body composition. The research also identified unique COMP fragmentation patterns in injured individuals versus uninjured ones, suggesting that how COMP breaks down could be a more sensitive indicator of joint damage. Furthermore, COMP levels were associated with MOAKS synovitis scores and FMI in injured participants, showcasing the relationship between inflammation, body composition, and cartilage health.

What are MOAKS and KOOS scores, and how are they used in the context of assessing knee injuries and osteoarthritis?

MOAKS, MRI Osteoarthritis Knee Scores, and KOOS, Knee Osteoarthritis Outcome Scores, are clinical assessments used to evaluate joint health and function. MOAKS assesses the presence and severity of various features of knee osteoarthritis using MRI, such as cartilage damage, bone marrow lesions, and synovitis. KOOS is a patient-reported outcome measure that evaluates pain, symptoms, function in daily living, function in sport and recreation, and knee-related quality of life. These scores provide researchers and clinicians with standardized methods to assess the extent of joint damage and the impact on a patient's activities and quality of life.

What are the implications of this research for the future of injury prevention and personalized approaches to joint health in young athletes?

While total COMP levels may not be definitive, COMP fragmentation patterns, in conjunction with other factors like body composition, specifically fat mass index or FMI, and MRI findings, could provide a more comprehensive assessment of joint health. Future research needs to focus on further elucidating the role of COMP fragmentation and identifying other potential biomarkers. These findings could promote personalized prevention strategies and early intervention for young athletes to mitigate the risk of developing osteoarthritis, OA, after a knee injury.