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Knee Osteoarthritis and Fracture Risk
Researchers writing in the medical journal Arthritis and
Rheumatism say "Patients with a clinical diagnosis of knee OA
(osteoarthritis) and with knee pain have an increased risk of
nonvertebral and hip fracture. This is not explained by the
increased risk of falls, but is more likely to be due to the
severity of falls sustained. Knee pain and OA should be regarded
as independent risk factors for fracture.
Arden NK, Crozier S, Smith H,
Anderson F, Edwards C, Raphael H, Cooper C. Knee pain, knee
osteoarthritis, and the risk of fracture. Arthritis Rheum. 2006
Aug 15;55(4):610-5.
OBJECTIVE: Patients with osteoarthritis (OA) have increased bone
mineral density; however, the association between knee OA and
fracture is controversial. Few data exist on the association
between knee pain and fracture. We examined the association of
knee OA and knee pain with fracture and falls in elderly men and
women.
METHODS: The study group comprised 6,641 men and women ages > or
=75 years who participated in a 3-year randomized controlled
trial of intramuscular vitamin D therapy. Patients completed a
questionnaire about knee pain and OA. Fracture and fall data
were collected prospectively every 6 months.
RESULTS: Knee pain prevalence and a clinician diagnosis of knee
OA were 35.2% and 6.8%, respectively. A total of 436 incident
nonvertebral fractures were reported, and 3,992 patients
sustained a fall. Prevalent knee pain was associated with an
increased risk of falls (hazard ratio [HR] 1.26, 95% confidence
interval [95% CI] 1.17-1.36) and hip fracture (HR 2.0, 95% CI
1.18-3.37). Increasing severity of knee pain was associated with
a greater risk of falls and hip fracture. Clinician diagnosis of
knee OA was associated with an increased risk of nonvertebral
fractures (HR 1.61, 95% CI 1.09-2.36). The increased risk of
fracture was not substantially reduced by adjusting for falls,
but was attenuated by adjustment for the use of walking aids.
CONCLUSION: Patients with a clinical
diagnosis of knee OA and with knee pain have an increased risk
of nonvertebral and hip fracture. This is not explained by the
increased risk of falls, but is more likely to be due to the
severity of falls sustained. Knee pain and OA should be regarded
as independent risk factors for fracture. |
