The Challenges in the Primary Prevention of Osteoarthritis

Runhaar, Jos; Bierma-Zeinstra, Sita M A

doi:10.1016/j.cger.2021.11.012

Cited by 9 publications

(7 citation statements)

References 71 publications

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“…Future randomized controlled trials (RCTs) are required to determine any potential causality of weight loss in reducing the incidence of knee replacement. Setting up such long‐term RCTs for knee replacement is challenging because osteoarthritis develops and progresses slowly ( 46 ). However, surrogate outcomes instead of knee replacement determining end‐stage knee osteoarthritis ( 47 ) could be used in such RCTs in the future.…”

Section: Discussionmentioning

confidence: 99%

Association Between Change in Body Mass Index and Knee and Hip Replacements: A Survival Analysis of Seven to Ten Years Using Multicohort Data

Salis

Sainsbury

2023

Arthritis Care & Research

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Objective To define the association between change in body mass index (BMI) and the risk of knee and hip replacement. Methods We used data from 3 independent cohort studies: the Osteoarthritis Initiative (OAI), the Multicenter Osteoarthritis Study (MOST), and the Cohort Hip and Cohort Knee (CHECK) study, which collected data from adults (45–79 years of age) with or at risk of clinically significant knee osteoarthritis. We conducted Cox proportional hazards regression analysis with clustering of both knees and hips per person to determine the association between change in BMI (our exposure of interest) and the incidence of primary knee and hip replacement over 7–10 years’ follow‐up. Change in BMI (in kg/m2) was calculated between baseline and the last follow‐up visit before knee or hip replacement, or for knees and hips that were not replaced, the last follow‐up visit. Results A total of 16,362 knees from 8,181 participants, and 16,406 hips from 8,203 participants, were eligible for inclusion in our knee and hip analyses, respectively. Change in BMI was positively associated with the risk of knee replacement (adjusted hazard ratio [HRadj] 1.03 [95% confidence interval (95% CI) 1.00–1.06]) but not hip replacement (HRadj 1.00 [95% CI 0.95–1.04]). The association between change in BMI and knee replacement was independent of participants’ BMI category at baseline (i.e., normal, overweight, or obese). Conclusion Public health strategies incorporating weight loss interventions could reduce the burden of knee but not hip replacement surgery.

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Section: Discussionmentioning

confidence: 99%

Association Between Change in Body Mass Index and Knee and Hip Replacements: A Survival Analysis of Seven to Ten Years Using Multicohort Data

Salis

Sainsbury

2023

Arthritis Care & Research

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“…Although research into the primary prevention of osteoarthritis (OA) in general, and of hip OA in particular, is in its infancy [ 7 , 22 , 27 ], the huge burden of hip osteoarthritis (OA) on patients, society, and the healthcare system, together with the rising prevalence and the small-to-moderate nonsurgical treatment effects [ 6 , 7 , 14 ], make efforts around the primary prevention of hip OA highly relevant [ 23 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors and Population-Attributable Fractions for Incident Hip Osteoarthritis

Runhaar,

van Berkel,

Agricola

et al. 2023

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Despite the huge burden of hip osteoarthritis (OA) and the lack of effective treatment, research into the primary prevention of hip OA is in its infancy. Purpose: We sought to evaluate risk factors for incident clinical and incident radiographic hip OA among middle-aged and older adults, to evaluate the importance of risk factors from a preventive perspective, and to estimate the percentage of new cases attributable to these risk factors. Methods: We retrospectively reviewed data from the Rotterdam study, an open-population cohort study of individuals aged 55 years or older. Data including baseline age, sex, body mass index, smoking status, education level, diagnosis of diabetes, C-reactive protein (CRP), cam morphology, acetabular dysplasia, radiographic thumb OA, radiographic hip OA, and hip pain were assessed for their association with incident clinical hip OA and incident radiographic hip OA separately, after 11 years of follow-up. The population-attributable fractions (PAFs) of statistically significant modifiable risk factors were calculated, as well. Results: New onset of clinical hip OA was seen in 19.9% (544 of 2729) and incident radiographic hip OA in 9.9% (329 of 3309). Female sex, education level below average (PAF 21.4%), and radiographic hip OA (PAF 3.4%) were statistically significantly associated with incident clinical hip OA. Female sex, age, overweight (PAF 20.0%), cam morphology (PAF 7.9%), acetabular dysplasia (PAF 3.6%), and radiographic thumb OA (PAF 4.7%) were statistically significantly associated with radiographic hip OA. Conclusions: Our retrospective analysis suggests that, from a primary prevention perspective, the most important modifiable risk factors among middle-aged and older individuals may be low educational level for incident clinical hip OA and overweight for incident radiographic hip OA. Further study is warranted.

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“…Osteoarthritis (OA) is a degenerative and progressive joint disease affecting more than 25% of the adult population [ 1 , 2 ]. Multiple factors contribute to the risk of developing OA, including genetic predisposition, sport injuries, physical work overload, obesity, and aging [ 3 ]. OA is one of the most common causes of adult disability worldwide.…”

Section: Introductionmentioning

confidence: 99%

Physical activity after revision knee arthroplasty including return to sport and work: a systematic review and meta-analysis including GRADE

Wilk

Hoorntje

Blankevoort

et al. 2023

BMC Musculoskelet Disord

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Background The number of primary knee arthroplasties (KAs) performed annually is rising, especially among active, working age patients. Consequently, revision KA is also increasingly performed. Our aim was to systematically review the extent to which patients were physically active following revision KA, and the rate and timing of return to sport and work. Methods A search was conducted in the databases Medline and Embase until February 24th, 2023. Studies describing patients with revision total knee arthroplasty (rTKA) or revision unicondylar knee arthroplasty (rUKA), with outcomes regarding physical activity or return to sport (RTS) or work (RTW) were included. Quality of studies was assessed using the Newcastle–Ottawa scale, meta-analyses were performed using RevMan 5.4 and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Results Of the 4,314 articles screened, 22 studies were included describing 2,462 rTKA patients (no rUKA), 42% were male with a mean age of 67 years (range 24 – 95). No studies reported objective physical activity measurements. Twenty-two studies reported patient reported outcome measures (PROMs). The PROMs that were pooled on a scale from zero to ten were the UCLA Activity Score, the Tegner Activity Level Scale, the Lower-Extremity Activity Scale, Devane Activity Score, and physical activity related subscales of the Knee injury and Osteoarthritis Outcome Score. The retrospective studies of moderate quality showed a statistically significant postoperative improvement of 1.7 points (MD = 1.71, 95% CI 1.48 – 1.94 (p < 0.0001); 14 studies, n = 1,211). For the prospective moderate-quality studies, a statistically significant postoperative increase of 0.9 points was found (MD = 0.89, 95% CI 0.48 – 1.30 (p < 0.0001); 6 studies, n = 1,027). Regarding RTS, 12% of patients participated in so-called ‘non-recommended’ activities (i.e., hockey, soccer, football, gymnastics, jogging, singles tennis, and basketball) after rTKA (1 study, n = 206). The pooled RTW was 86% (2 studies, range 18–95%, n = 234). Conclusions The majority of patients self-reported an improved postoperative activity level after rTKA. Patients could maintain an active lifestyle in daily life, including sports and work. For reliable physical activity, RTS and RTW estimations, more studies are required. In terms of GRADE, the quality of evidence for the five prospective studies was rated as low. Level of evidence Level 3.

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The Challenges in the Primary Prevention of Osteoarthritis

Cited by 9 publications

References 71 publications

Association Between Change in Body Mass Index and Knee and Hip Replacements: A Survival Analysis of Seven to Ten Years Using Multicohort Data

Association Between Change in Body Mass Index and Knee and Hip Replacements: A Survival Analysis of Seven to Ten Years Using Multicohort Data

Risk Factors and Population-Attributable Fractions for Incident Hip Osteoarthritis

Physical activity after revision knee arthroplasty including return to sport and work: a systematic review and meta-analysis including GRADE

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