Risk factors for knee replacement due to primary osteoarthritis

Post on June 25, 2014 by André Broussard, D.C.

Risk factors for knee replacement due to primary osteoarthritis, a population based, prospective cohort study of 315,495 individuals

BMC Musculoskeletal Disorders, 06/25/2014  Evidence Based Medicine  Clinical Article

PubMed Reference
Journal Reference

BMC Musculoskeletal Disorders

Apold H, et al. – Osteoarthritis (OA) of the knee is a common and disabling condition. Authors wanted to investigate the modifiable risk factors Body Mass Index (BMI) and physical activity, using knee replacement (KR) as a marker for severely symptomatic disease, focusing on the interaction between these risk factors. They found that a high BMI and intensive physical activity at work both contribute strongly to the risk of having a KR. As the two risk factors seem to act independently, people with strenuous physical work with a high BMI are at particularly high risk for severely disabling OA of the knee, and should be targeted with effective preventive measures.

Methods

  • 315,495 participants (mean age 43.0 years) from national health screenings were followed prospectively with respect to KR identified by linkage to the Norwegian Arthroplasty Register.
  • Data were analysed by Cox proportional hazard regression.

Results

  • During 12 years of follow up 1,323 individuals received KR for primary OA.
  • There was a dose–response relationship between BMI and heavy labour, and later KR.
  • Comparing the highest versus the lowest quarter of BMI, the relative risk was 6.2 (95% CI: 4.2–9.0) in men and 11.1 (95% CI: 7.8–15.6) in women.
  • Men reporting intensive physical activity at work had a relative risk of 2.4 (95% CI: 1.8–3.2) versus men reporting sedentary activity at work, the corresponding figure in women being 2.3 (95% CI: 1.7–3.2).
  • The effect of BMI and physical activity at work was additive.
  • The heaviest men with the most strenuous work had a RR of 11.7 (95% CI: 5.9–23.1) compared to the ones with the lowest BMI and most sedentary work.
  • For women the corresponding RR was 15.8 (95% CI: 8.2–30.3).
  • There was no association between physical activity during leisure and KR.
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