Osteoarthritis (OA) is a significant health problem, with studies suggesting that the condition affects up to 10% of men and 18% of women over the age of 60. Previous research has suggested that some physical risk factors may be associated with a higher rate of early onset OA. “There is an increasing need to address joint damage and its relationship to injuries, participation in sports, being physically active, being overweight or obese, and occupational activity so that we can better inform patients on strategies to prevent OA,” says Sarah A. Richmond, CEP, MSc, PhD. “This information can also help clinicians address the rising healthcare burden associated with OA.”
In the Journal of Orthopaedic and Sports Physical Therapy, Dr. Richmond and colleagues published a systematic review and meta-analysis that addressed this issue. According to the results, there was an increased risk for either knee or hip OA in individuals with previous joint injuries, those who were overweight or obese, and those who had physically demanding occupations, especially jobs that involved squatting or kneeling activities. Some findings, however, remain inconclusive, including levels of physical activity and sport-specificity in individuals who did not suffer an injury.
“Overall, joint injury was a significant risk factor for knee OA, with individuals who had suffered a previous knee injury at a three- to eight-fold greater risk of OA than individuals with no history of injury,” Dr. Richmond says. Joint injury was also a risk factor for hip OA, as was previous meniscectomy with or without ACL injury.
Dr. Richmond notes that a clear understanding of the implications of the risk factors reviewed in her study team’s analysis should be further investigated. “Early identification of people at risk for OA may lead to the implementation of early treatment before the disease becomes more costly to manage,” she says. “The healthcare burden of OA on society is significant and continues to worsen as people are living longer. We need to conduct and analyze more high-quality studies when we examine the relationship of physical risk factors with OA. In the meantime, our study should be viewed by clinicians in the context of increasing awareness among patients about their role in preventing OA.”
Clinicians should take a proactive approach to OA prevention strategies, according to Dr. Richmond. “With OA, clinicians have an opportunity to expand their role as primary prevention educators. Clinicians already inquire about patients’ history, occupational activities, physical activities, and sports. Now, we need to take the next step and serve as key stakeholders by actively prescribing exercise and rehabilitation.”
Richmond SA, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA. Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review. J Orthop Sports Phys Ther. 2013 Jun 11 [Epub ahead of print]. Available at: http://www.jospt.org/issues/id.2900/article_detail.asp.
Vignon E, Valat JP, Rossignol M, et al. Osteoarthritis of the knee and hip and activity: a systematic international review and synthesis (OASIS). Joint Bone Spine. 2006;73:442-455.
Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16:137-162. Available at: http://www.oarsi.org/pdfs/oarsi_recommendations_for_management_of_hip_and_knee_oa.pdf.
American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. May 18, 2013. Available at: http://www.aaos.org/research/guidelines/TreatmentofOsteoarthritisoftheKneeGuideline.pdf.