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Knee pain, knee osteoarthritis, and the risk of fracture

Knee pain, knee osteoarthritis, and the risk of fracture
Knee pain, knee osteoarthritis, and the risk of fracture
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 >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.
knee pain, osteoarthritis, fracture, falls.
0004-3591
610-615
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Crozier, Sarah
a9c88016-8f46-4659-954e-4d7af8a49594
Smith, Helen
42562879-cabb-497a-9209-ae8c6530b37d
Anderson, Frazer
ed26ec76-5200-4927-b39a-3f96f8ffeb43
Edwards, Christopher
dcb27fec-75ea-4575-a844-3588bcf14106
Raphael, Helen
ea9c57e6-b5cb-4d93-9c9f-605fcb9d8000
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Crozier, Sarah
a9c88016-8f46-4659-954e-4d7af8a49594
Smith, Helen
42562879-cabb-497a-9209-ae8c6530b37d
Anderson, Frazer
ed26ec76-5200-4927-b39a-3f96f8ffeb43
Edwards, Christopher
dcb27fec-75ea-4575-a844-3588bcf14106
Raphael, Helen
ea9c57e6-b5cb-4d93-9c9f-605fcb9d8000
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6

Arden, Nigel K., Crozier, Sarah, Smith, Helen, Anderson, Frazer, Edwards, Christopher, Raphael, Helen and Cooper, Cyrus (2006) Knee pain, knee osteoarthritis, and the risk of fracture. Arthritis & Rheumatism, 55 (4), 610-615. (doi:10.1002/art.22088).

Record type: Article

Abstract

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 >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.

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More information

Published date: 2006
Keywords: knee pain, osteoarthritis, fracture, falls.
Organisations: Dev Origins of Health & Disease

Identifiers

Local EPrints ID: 44149
URI: https://eprints.soton.ac.uk/id/eprint/44149
ISSN: 0004-3591
PURE UUID: e578df82-b425-4133-8fd5-b2e39df0d659
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 16 Feb 2007
Last modified: 14 Mar 2019 01:50

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Contributors

Author: Nigel K. Arden
Author: Sarah Crozier
Author: Helen Smith
Author: Frazer Anderson
Author: Helen Raphael
Author: Cyrus Cooper ORCID iD

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