Body weight at early and middle adulthood, weight gain and persistent overweight from early adulthood are predictors of the risk of total knee and hip replacement for osteoarthritis.

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Cancer Epidemiology Centre, Cancer Council Victoria, Carlton, Victoria, Department of Orthopaedics, Repatriation General Hospital, Daw Park, South Australia, Australian Orthopaedic Association National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, South Australia, Australia and Department of Surgery, Epworth HealthCare, University of Melbourne, Richmond, Victoria.
Rheumatology (Oxford, England) (Impact Factor: 4.44). 01/2013; DOI: 10.1093/rheumatology/kes419
Source: PubMed

ABSTRACT Objectives. To examine the relationships between weight at early and middle adulthood and adult weight gain and the risk of total knee and hip replacement for OA.Methods. At baseline interview during 1990-94, 38 149 participants [mean age 54.9 (s.d. 8.6) years] of the Melbourne Collaborative Cohort Study were asked to recall their weight at age 18-21 years and had their middle age height and weight measured. Total knee and hip replacement for OA between 2001 and 2009 was determined by linking the cohort records to the Australian Orthopaedic Association National Joint Replacement Registry.Results. Greater weight and BMI at age 18-21 years and middle age, weight gain and persistent overweight during this time were associated with an increased risk of total knee and hip replacement. Middle age weight [hazard ratio (HR) per 5 kg 1.25 (95% CI 1.23, 1.27) for knee vs 1.11 (1.09, 1.14) for hip] and BMI [HR per 5 kg/m(2) 1.80 (1.72, 1.89) vs 1.29 (1.21, 1.37)] and adult weight gain [HR per 5 kg 1.25 (1.23, 1.28) vs 1.10 (1.07, 1.13)] were more strongly associated with the risk of total knee replacement than total hip replacement (P for heterogeneity of HRs <0.0001).Conclusion. Greater body weight and BMI at early and middle adulthood, weight gain and persistent overweight from early to middle adulthood are risk factors for knee and hip OA. Adult weight gain confers stronger risk on knee OA than hip OA. Weight control from early adulthood and avoiding weight gain are important for the prevention of OA.

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    ABSTRACT: Osteoarthritis (OA) of the knee is a common and disabling condition. We 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.
    BMC Musculoskeletal Disorders 06/2014; 15(1):217. DOI:10.1186/1471-2474-15-217 · 1.90 Impact Factor
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    ABSTRACT: Objective: To investigate the risk of total hip replacement (THR) due to primary osteoarthritis in relation to cumulative occupational mechanical exposures and lifestyle factors.Methods: Using register information, we identified first-time THR cases within the Danish working population, 2005-2006. Two age- and sex-matched controls were drawn. Persons within 2500 randomly selected case-control sets received a questionnaire on job history, weight at age 25, present weight and height, smoking, and sports activities at age 25. Job history was combined with a job exposure matrix. Cumulative exposure estimates were expressed according to the pack-year concept of smoking (e.g. cumulative lifting expressed as ton-years). We used conditional logistic regression.Results: 1776 (71%) case-control sets contributed. The adjusted odds ratio for exposure to ≥20 ton-years was 1.37 (95% CI 1.06-1.75) for men and 1.02 (95% CI 0.73-1.42) for women. Standing/walking and whole body vibration showed no associations. The adjusted odds ratio for body mass index (BMI) ≥30 kg/m2 at age 25 was 2.45 (95% CI 1.40-4.32) for men and 5.23 (95% CI 2.35-11.64) for women. The corresponding adjusted odds ratios for an increase in BMI of ≥10 kg/m2 since age 25 were 2.19 (95% CI 1.28-3.73) and 2.44 (95% CI 1.46-4.09). Sports participation showed weak positive associations, while pack-years of smoking showed no associations.Conclusion: Results indicated a modest increase in risk of THR in relation to cumulative lifting among men and an increased risk in relation to a high BMI at age 25 and to a gain in BMI in both sexes. © 2014 American College of Rheumatology.
    10/2014; 66(10). DOI:10.1002/acr.22326
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    ABSTRACT: Objective To study the association between weight gain and the risk of knee replacement (KR) due to primary osteoarthritis (OA), and to evaluate whether the association differs by age. Design 225,908 individuals from national health screenings with repeated measurements of height and weight were followed prospectively with respect to KR identified by linkage to the Norwegian Arthroplasty Register. Cox proportional hazard regression was used to calculate sex-specific relative risks of KR according to change in BMI and weight, corresponding analyses were done for age categories at first screening. Results During 12 years of follow up, 1,591 participants received a KR due to primary OA. Men in the highest quarter of yearly change in BMI had a relative risk of 1.5 (95% CI 1.1-1.9) of having a KR compared to those in the lowest quarter. For women the corresponding relative risk was 2.4 (95% CI 2.1-2.7). Men under the age of 20 at the first screening had a 26% increased risk for KR per 5 kilogram weight gain, for women the corresponding increase was 43%. At older age the association became weaker, and in the oldest it was lost. Conclusions Weight gain increases the risk for later KR both in men and women. The impact of weight gain is strongest in the young, at older age the association is weak or absent. Our study suggests that future OA may be prevented by weight control and that preventive measures should start at an early age.
    Osteoarthritis and Cartilage 01/2014; DOI:10.1016/j.joca.2014.03.002 · 4.66 Impact Factor