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PubMed1989

HLA-A, B antigens and alpha 1-antitrypsin phenotypes in nodal generalised osteoarthritis and erosive osteoarthritis.

HLA-A, B and alpha 1-antitrypsin phenotypes were studied in 90 unrelated patients with established nodal generalised osteoarthritis (OA). Compared with standard reference populations, independently increased frequency of the HLA-A1B8 and MZ alpha 1-antitrypsin phenotypes were observed (27% v 11.5%, relative risk 2.79, and 12% v 3.6%, relative risk 3.73 respectively). These associations related to developed of nodal generalised OA rather than to severity as judged by the summated radiographic scores for hand OA. Ten patients had marked subchondral radiographic erosions and were further classified as erosive OA; these patients had an increased frequency of the MS alpha 1-antitrypsin phenotype (30% v 9%) and higher radiographic OA scores corrected for presence of erosions. This first report of two independent genetic markers in nodal generalised OA is of interest in relation to the increasingly recognised inflammatory component of the osteoarthritis process.

Aged↗

PubMed1996

Hypermobility associated with osteoarthritis of the thumb base: a clinical and radiological subset of hand osteoarthritis.

OBJECTIVES: To study the impact of articular hypermobility on the clinical and radiological features of hand osteoarthritis (OA) and to investigate whether hand osteoarthritis associated with hypermobility should be considered a separate subset of hand OA. METHODS: Fifty consecutive female patients with clinical hand OA and thumb base symptoms were examined for hypermobility according to the Beighton criteria. RESULTS: Thirty one of the 50 patients had hypermobility features (Beighton score > or = 2) and 17 patients fulfilled four or more Beighton criteria. Corresponding figures for 94 control patients were 30 (p < 0.05) and nine (p < 0.001) respectively. Patients with hypermobility features were characterised clinically and radiologically by fewer and less severely involved interphalangeal joints. Radiologically, two fairly distinct subsets could be identified: Severe interphalangeal OA in which the prevalence of hypermobility was similar to controls, and patients with predominant involvement of the first carpometacarpal joint (CMC 1), most of whom had evidence of hypermobility. CONCLUSION: A causal relation exists between articular hypermobility and development of thumb base OA, and hypermobility associated hand OA constitutes a definite clinical and radiological subset of hand OA. In the clinical setting, the easily applied hypermobility criterion of passive dorsiflexion of the fifth finger > or = 90 degrees is useful in identifying most patients with hand OA and hypermobility.

Aged↗

PubMed2000

Minimal perceptible clinical improvement with the Western Ontario and McMaster Universities osteoarthritis index questionnaire and global assessments in patients with osteoarthritis.

OBJECTIVE: To determine the minimal perceptible clinical improvement (MPCI) in patients with osteoarthritis (OA) with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, and patient and investigator global assessment of disease status in randomized clinical trials for treatment of OA. METHODS: Subjects with OA of the knee or hip were randomized to receive either rofecoxib 12.5 or 25 mg once daily, ibuprofen 800 mg 3 times daily, or placebo for 6 weeks. The WOMAC and global assessments were completed at baseline and Weeks 2, 4, and 6. A patient global assessment of response to therapy (0 to 4 scale) was used to "anchor" the WOMAC scores. MPCI was defined as the difference in mean change from baseline in WOMAC (100 mm normalized visual analog scale, VAS) between patients with 0 = "None" global response to therapy and patients with 1 = "Poor" global response to therapy. RESULTS: MPCI was determined to be 9.7, 9.3, and 10.0 mm for the WOMAC pain, physical function and stiffness subscales, respectively, and 11.1 mm for WOMAC question 1: Pain walking on a flat surface. The MPCI for the investigator was 0.4 with investigator assessment of disease status reported on a 0 to 4 Likert scale. Of note, the estimated MPCI for the WOMAC and investigator globals were similar irrespective of treatment, sex, age, or geographic region. CONCLUSION: In this analysis, mean changes of roughly 9 to 12 mm (100 mm normalized VAS) on WOMAC scales were perceptible changes to patients with hip and knee OA. A mean decrease of 0.4 in global disease status (0 to 4 Likert scale) as assessed by the investigator corresponded to the patients' MPCI. Understanding the minimal perceptible differences may permit a better assessment of the clinical relevance of therapeutic interventions in OA.

Adult↗

PubMed2002

The longterm outcome of osteoarthritis: rates and predictors of joint space narrowing in symptomatic patients with knee osteoarthritis.

OBJECTIVE: To determine the rate of progression of radiographic joint space narrowing (JSN) and the factors that predict it in symptomatic clinic patients with knee osteoarthritis (OA). METHODS: In total 1,507 patients with knee OA were studied with extended weight-bearing anterior-posterior views of the knee as part of a longitudinal study of longterm outcomes of osteoarthritis (OA). Baseline demographic and severity measurements included body mass index (BMI), pain, global severity, Health Assessment Questionnaire disability, and erythrocyte sedimentation rate. Rates and predictors of progression were obtained by Kaplan-Meier survival analyses and Cox regressions using a JSN score of 3 as "failure." RESULTS: For the 1,232 patients who had not reached the endpoint narrowing score of 3 when first evaluated, the 75th and 50th survival times (time to JSN = 3) were 11.27 and 17.84 years for those with JSN = 0 at onset, 7.41 and 12.03 years for those with JSN = 1 at onset, and 4.49 and 7.44 years for those with JSN = 2 at onset. The corresponding yearly incidence rates for the 3 initial groups were 0.017, 0.032, and 0.077. In multivariate Cox models, initial JSN, BMI, symptom duration, and global severity were predictors of progression, but only JSN was a strong predictor. BMI predicted JSN in those with JSN = 0 at onset, but not in patients with more severe disease. Although contralateral JSN predicted progression, it was only of value with initial homolateral JSN scores of 0. Assessment of homolateral osteophytes aided prediction in patients with initial JSN = 0, but was of much less help when JSN had a higher severity score. CONCLUSION: The risk of progression in clinical OA patients with radiographic abnormalities is substantial. Nonradiographic predictors of OA progression (e.g., BMI) are weak predictors of radiographic progression compared to current radiographic status. Rates of progression are greatest in those with established radiographic abnormalities. Osteophytes are of limited additional values once JSN = 2 is present. Contralateral radiographic abnormalities are useful predictors only in those with JSN = 0. Intervention studies to prevent radiographic progression probably should utilize joints where evidence of abnormality already exists. At a clinical level, current radiographic status predicts future status, with 50% of patients with JSN = 1 and 50% of patients with JSN = 2 progressing to complete joint space loss in 12.03 and 7.44 years, respectively.

Age Factors↗

PubMed2002

Absence of linkage or association for osteoarthritis with the vitamin D receptor/type II collagen locus: the Framingham Osteoarthritis Study.

OBJECTIVE: Studies have suggested that polymorphisms or mutations either in the COL2A1 or VDR gene. both on chromosome 12q, are associated with the occurrence of osteoarthritis (OA). We examined linkage and association between the VDR/COL2A1 locus and hand/knee OA in the Framingham Osteoarthritis Study (FOS). METHODS: Hand and knee joints were characterized radiographically in the FOS. An overall score for OA using the standard Kellgren and Lawrence grading scheme was determined, as well as scores for individual features of OA including osteophytes and joint space narrowing. For linkage studies, polymorphic microsatellite markers near the VDR-COL2AI genes on chromosome 12 were tested in a collection of 296 of the largest Framingham Heart Study families and the results analyzed using variance component linkage (SOLAR). For association studies, we characterized the allele status of a subset of subjects at the BsmI site of the VDR gene. RESULTS: Overall, we found no linkage or association between OA and the COL2A1/VDR locus for either knee or hand OA, nor did we find an association or linkage between COL2AI or VDR with any individual radiographic features of OA. CONCLUSION: Despite studies suggesting associations of OA with both COL2A1 and VDR loci, our results suggest that mutations at the COL2A1/VDR locus do not play an important role as a cause of common OA in the population at large.

Aged↗

PubMed2005

Structural factors associated with malalignment in knee osteoarthritis: the Boston osteoarthritis knee study.

OBJECTIVE: Osteoarthritis (OA) is a multifactorial condition. The progression of knee OA is determined in part by mechanical effects on local structures. One of the mechanical influences on cartilage loss is limb alignment. We explored the structural factors associated with malalignment in subjects with symptomatic OA. METHODS: We conducted a cross-sectional assessment using The Boston Osteoarthritis of the Knee Study, a natural history study of symptomatic knee OA. Baseline assessments included knee magnetic resonance imaging (MRI) and information on weight and height. Long-limb radiographs to assess mechanical alignment were obtained at 15 months. Subarticular bone attrition, meniscal degeneration, anterior and posterior cruciate ligament integrity, medial and lateral collateral ligament integrity, marginal osteophytes, and cartilage morphology were assessed on MRI using a semiquantitative, multi-feature scoring method (Whole-Organ MRI Score) for whole-organ evaluation of the knee that is applicable to conventional MRI techniques. We also quantified the following meniscal position measures on coronal MRI images in both medial and lateral compartments: subluxation, meniscal height, and meniscal covering of the tibial plateau. Using the long-limb radiographs, mechanical alignment was measured in degrees on a continuous scale. The purpose of this cross-sectional analysis was to determine the individual and relative contribution of various structural factors to alignment of the lower extremity. We assessed the cross-sectional association between various structural factors and alignment of the lower extremity using a linear regression model. RESULTS: The 162 subjects with all measures acquired had a mean age of 67.0 years (SD 9.2), body mass index 31.4 (SD 5.6); 30% were female and 77% of knees had a Kellgren-Lawrence grade > or = 2. The main univariate determinants of varus alignment in decreasing order of influence were medial bone attrition, medial meniscal degeneration, medial meniscal subluxation, and medial tibiofemoral cartilage loss. Multivariable analysis revealed that medial bone attrition and medial tibiofemoral cartilage loss explained more of the variance in varus malalignment than other variables. The main univariate determinants of valgus malalignment in decreasing order of influence were lateral tibiofemoral cartilage loss, lateral osteophyte score, and lateral meniscal degeneration. CONCLUSION: Cartilage loss has been thought to be the major determinant of alignment. We found that other factors including meniscal degeneration and position, bone attrition, osteophytes, and ligament damage contribute to the variance of malalignment. Further longitudinal analysis is required to determine cause and effect relationships. This should assist researchers in determining strategies to ameliorate the potent effects of this mechanical disturbance.

Aged↗

PubMedDate not supplied

The WOMAC Knee and Hip Osteoarthritis Indices: development, validation, globalization and influence on the development of the AUSCAN Hand Osteoarthritis Indices.

Clinical measurement in both clinical research and clinical practice requires tools and techniques that are valid, reliable and responsive. Patient-centred self-reported measures provide opportunity to evaluate consequences of osteoarthritis, that are important and relevant to patients with the condition. The WOMAC and AUSCAN Indices are health status measurement questionnaires that are valid, reliable and responsive, easy to complete, simple to score and available in multiple language forms and scaling formats. They provide opportunities to capture patient relevant information, relating to the impact of interventions, in clinical research and clinical practice environments. WOMAC data have also contributed to the development of proposed definitions for responder criteria and state-attainment criteria in osteoarthritis.

Biomedical Research↗

PubMed2007

Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project.

OBJECTIVE: To report contemporary estimates of the prevalence of knee-related osteoarthritis (OA) outcomes in African Americans and Caucasians aged > or = 45 years. METHODS: Weighted prevalence estimates for knee symptoms, radiographic knee OA, symptomatic knee OA, and severe radiographic knee OA were calculated for age, ethnic, and sex subgroups, in 3018 participants (33% African Americans, 38% men) in the baseline examination (1991-97) of The Johnston County Osteoarthritis Project, a population-based study of OA in North Carolina. Radiographic knee OA was defined as Kellgren-Lawrence radiographic grade > or = 2, severe radiographic knee OA as grades 3 and 4, and symptomatic knee OA as knee symptoms in a knee with radiographic OA. RESULTS: Knee symptoms were present in 43%, 28% had radiographic knee OA, 16% had symptomatic knee OA, and 8% had severe radiographic knee OA. Prevalence was higher in older individuals and women. African Americans had slightly higher prevalence of knee symptoms, radiographic knee OA, and symptomatic knee OA, but significantly higher prevalence of severe radiographic knee OA compared to Caucasians. CONCLUSION: Policy should be directed to increasing education of the public and the medical community about the high prevalence of these conditions, especially in these subgroups, to decrease their impact and ultimately prevent them.

Black or African American↗

PubMed1997

Design and conduct of clinical trials in osteoarthritis: preliminary recommendations from a task force of the Osteoarthritis Research Society.

In 1994, a combined committee of the World Health Organization and the International League of Associations for Rheumatology published recommendations for clinical trials for 2 classes of agents for treatment of osteoarthritis (OA) that relieved symptoms but differed in their onset and duration of response, and a third class of agents that may alter the disease process. Recently, the European Group for the Respect of Ethics and Excellence in Science made recommendations for methods to be used in the registration of drugs for OA. Following the 2nd international meeting of the Osteoarthritis Research Society in December 1994, a task force was convened to develop recommendations for the design and conduct of clinical trials in patients with OA. The Task Force had several meetings over the past 16 months, resulting in the preliminary recommendations summarized here.

Clinical Trials as Topic↗

PubMed1997

Knee pain and knee osteoarthritis severity in self-reported task specific disability: the Johnston County Osteoarthritis Project.

OBJECTIVE: To evaluate the contributions of radiographic knee osteoarthritis (OA) and knee pain severity to self-reported disability performing upper and lower extremity tasks in a rural, population based sample. METHODS: Data from 1192 African-American and Caucasian participants in the Johnston County Osteoarthritis Project were analyzed with multiple logistic regression to examine the roles of Kellgren-Lawrence radiographic knee OA grade and knee pain severity in self-reported difficulty performing 20 activities of the Health Assessment Questionnaire. Potential confounders included age, sex, race, marital status, education, and body mass index. RESULTS: Forty-three percent reported difficulty performing at least one task. Mild knee pain was independently associated with difficulty performing 16 upper and lower extremity tasks, and moderate/severe knee pain with all 20 tasks, with little change after adjustment (p < 0.0001). In contrast, mild radiographic knee OA was associated with difficulty in only 4 mobility and transfer tasks: climbing 5 steps, taking a tub bath, getting in/out of a car, and performing chores. Moderate/severe radiographic knee OA was associated with difficulty in 17 of 20 tasks (in 10 of 17, p < 0.0001), except lifting a cup, opening car doors, and turning faucets. However, no associations between radiographic knee OA and difficulty were statistically significant after adjustment for knee pain and the above factors. CONCLUSION: Knee pain severity was the strongest risk factor for self-reported difficulty performing tasks of upper and lower extremity function. Future studies of disability should include data on knee pain severity.

Activities of Daily Living↗

PubMed2000

Comparison of the effect of rofecoxib (a cyclooxygenase 2 inhibitor), ibuprofen, and placebo on the gastroduodenal mucosa of patients with osteoarthritis: a randomized, double-blind, placebo-controlled trial. The Rofecoxib Osteoarthritis Endoscopy Multinational Study Group.

OBJECTIVE: This randomized, double-blind study tested the hypothesis that rofecoxib, a drug that specifically inhibits cyclooxygenase 2, would cause fewer gastroduodenal ulcers than ibuprofen (in a multicenter trial), and its side effects would be equivalent to those of placebo (in a prespecified analysis combining the results with another trial of identical design). METHODS: Seven hundred seventy-five patients with osteoarthritis were randomized to receive rofecoxib at a dosage of 25 mg or 50 mg once daily, ibuprofen 800 mg 3 times daily, or placebo. Gastroduodenal ulceration was assessed by endoscopy at 6, 12, and (for active treatment) 24 weeks. The primary and secondary end points were the incidence of gastroduodenal ulcers at 12 and 24 weeks, respectively. RESULTS: Ulcers were significantly less common (P < 0.001) following treatment with rofecoxib (25 mg or 50 mg) than with ibuprofen after 12 weeks (5.3% and 8.8% versus 29.2%, respectively) or 24 weeks (9.9% and 12.4% versus 46.8%, respectively). In the combined analysis, the 12-week ulcer incidence with 25 mg rofecoxib (4.7%) and with placebo (7.3%) satisfied prespecified criteria for equivalence. CONCLUSION: At 2-4 times the therapeutically effective dose, rofecoxib caused fewer endoscopically detected ulcers than did ibuprofen. Rofecoxib at a dose of 25 mg (the highest dose recommended for osteoarthritis) satisfied prespecified criteria for equivalence to placebo.

Cyclooxygenase Inhibitors↗

PubMed2005

Does hand osteoarthritis predict future hip or knee osteoarthritis?

OBJECTIVE: To evaluate the risk of future hip or knee osteoarthritis (OA) in subjects with hand OA at baseline and to evaluate whether the concurrent presence of hand OA, other risk factors for OA, or an OA biomarker (type II collagen C-telopeptide degradation product [CTX-II]) further increases the risk. METHODS: Radiographs of the hands (baseline) and the hips and knees (baseline and 6.6 years later) were obtained in a randomly selected subset of participants in the Rotterdam Study who were ages 55 years and older. Radiographs were scored for the presence of OA using the Kellgren/Lawrence (K/L) system. A total of 1,235 subjects without OA of the hip/knee (K/L score 0-1) at baseline were included in the study. CTX-II levels were measured at baseline. The independent risk of future hip/knee OA in subjects with hand OA at baseline was assessed by logistic regression, as stratified for age, sex, body mass index, family history of OA, and heavy workload. RESULTS: Overall 12.1% of the participants (19.7% of those with hand OA versus 10.0% of those without) developed hip or knee OA (odds ratio [OR] 2.1 [95% confidence interval (95% CI) 1.3-3.1]). Subjects with hand OA had an increased risk of future hip OA (OR 3.0 [95% CI 1.6-5.4]), which was further increased in those with a family history of OA. Subjects with hand OA had an OR of 1.6 [95% CI 1.0-2.8) for the future development of knee OA, which was further increased in those who were overweight. Concurrent hand OA and high levels of CTX-II further increased the risk of having hip or knee OA at followup (OR 4.2 [95% CI 2.3-7.8]). CONCLUSION: The presence of hand OA at baseline showed an increased risk of future hip/knee OA (higher for hip OA than for knee OA). The concurrent presence of hand OA and other OA risk factors or high CTX-II levels further increased the risk of future hip/knee OA.

Aged↗

PubMed2000

Bone mineral density and bone turnover in patients with knee osteoarthritis compared with generalized osteoarthritis.

The aim of this study was to investigate bone mineral density (BMD) and bone turnover in patients with primary knee osteoarthritis (KOA) and to compare them with generalized OA (GOA) and nonGOA patients. A total of 88 postmenopausal primary KOA patients were studied. OA was graded by using knee radiographs. BMD of the lumber spine, femur, and radius, and biochemical markers of bone turnover, pyridinoline (Pyr), deoxypyridinoline (Dpyr), CTx, and osteocalcin were compared among each grade. BMD was also compared with 88 normal controls who were age and weight-matched. In 88 KOA patients, 56 were divided into 28 GOA and 28 non-GOA groups by grading hand radiographs. BMD and biochemical markers were compared between GOA and non-GOA. KOA patients had higher BMD at several skeletal sites compared with age- and weight-matched normals. A significant difference of BMD between each grade was observed between grades 0-1 and 3 (0.774+/-0.143 versus 0.940+/-0.185 g/cm(2), P<0.001), grades 2 and 3 (0.781+/-0.125 versus 0.940+/-0.185 g/cm(2), P<0.01) in the spine, and between grades 0-1 and 3 (0.505+/-0.100 versus 0.564+/-0.127 g/cm(2), P<0.05) in the trochanter. A significant difference of biochemical bone markers was observed between grades 0-1 and 3 (P<0.05) and between grades 2 and 3 (P<0.05) in Pyr and grades 0-1 and 3 (P<0.05) and between grades 1 and 4 (P<0.05) in Dpyr, but not in osteocalcin and CTx. GOA patients had higher BMD of the spine (0.902+/-0.175 versus 0.747+/-0.138 g/cm(2), P<0.01), trochanter (0.535+/-0.107 versus 0.480+/-0.107 g/cm(2), P<0.05), and one-third of the radius (0.526+/-0.068 versus 0.472+/-0. 089 g/cm(2), P<0.05) and had significantly higher biochemical markers in Pyr and Dpyr than non-GOA patients. It is concluded that KOA patients had higher BMD at several skeletal sites. Biochemical bone markers were influenced by some degree of cartilage damage in OA patients. This tendency was stronger in GOA patients than in non-GOA patients.

Aged↗

PubMed2001

[Physiotherapy in osteoarthritis--a review of literature on conservative therapy of knee and hip osteoarthritis].

In this review, 18 studies have been evaluated about the effectiveness of exercise therapy in the physiotherapy in osteoarthritis of hip or knee. All studies emphasised the general profit of exercise therapy compared to alternative programs (such as "health education", etc.). The effect sizes were mostly indicated to be moderate to large. There were no study comparing two or more alternative exercise programs in regard to the size of effectiveness. Only two studies gave informations about the radiographic grade of the OA. Today the effectiveness is proved only for aerobic, dynamic strengthening exercises. There were no study about the effectiveness of physiotherapy in Hip-OA.

Humans↗

PubMed1998

Comparison of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index and a self-report format of the self-administered Lequesne-Algofunctional index in patients with knee and hip osteoarthritis.

OBJECTIVE: To compare the metric properties and validity of German versions of the WOMAC (Western Ontario and McMaster Universities) and a self-administered questionnaire-format of the Lequesne-Algofunctional-Index in patients with osteoarthritis (OA) of the lower extremities. DESIGN: Cross-sectional analysis of the instruments' internal consistency (Cronbach's coefficient alpha) and construct validity (correlation with radiological OA-severity and limitation in range-of-motion) in ambulatory patients and patients before hip arthroplasty. Test-retest reliability was assessed on a subsample after 10 days. RESULTS: Data from 51 patients out of 91 contacted could be analyzed. Twenty-nine patients had knee and 22 patients had hip OA. Both the WOMAC and Lequesne OA-indices and their scales or sections had a satisfactory test-retest reliability (Intraclass correlation coefficient 0.43-0.96). All scales of the WOMAC were internally consistent (Cronbach's coefficient alpha 0.81-0.96) and associated with radiological OA-severity and joint range of motion. However, only the function but not the symptom sections (Cronbach's coefficient alpha knee: 0.55; hip: 0.63) of the self-administered Lequesne OA index were internally consistent for both, patients with knee and hip OA. Also, the symptom components were not or only weakly associated with radiological OA-severity and joint range of motion. CONCLUSIONS: Although our results are based on a German version using a self-report format we may caution using the self-administered Lequesne OA index without prior testing of its metric properties and validity.

Aged↗

PubMed1999

Superior responsiveness of the pain and function sections of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as compared to the Lequesne-Algofunctional Index in patients with osteoarthritis of the lower extremities.

OBJECTIVE: To compare the responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a questionnaire format of the Lequesne-Algofunctional Index in patients with OA of the lower extremities. METHODS: Longitudinal analysis of the instruments' responsiveness [standardized response mean (SRM), effect size (ES)] in ambulatory patients undergoing hip or knee arthroplasty. RESULTS: At six months 36, and at one year 40 out of 43 patients undergoing hip (N=30) or knee arthroplasty (N=13) could be examined. Both responsiveness statistics revealed the same order of responsiveness. For both indices and for both locations, the pain sections were more responsive than the function sections. However, the WOMAC scales and the WOMAC global index (hip at 12 months: SRM=2.4; knee at 12 months: SRM=2.0 ) were more responsive than the comparable Lequesne sections and Lequesne index (hip at 12 months: SRM=2.1; knee at 12 months: SRM=1.5). CONCLUSIONS: Although our results are based on a German version using a self-report format, the WOMAC scales appear to be more responsive than the Lequesne index in patients with OA of the lower extremities.

Adult↗

PubMed2001

Non-insulin dependent diabetes mellitus (NIDDM) and patterns of osteoarthritis. The Ulm osteoarthritis study.

OBJECTIVES: Despite recent advances regarding the role of diabetes with respect to cartilage metabolism, epidemiologic data to quantify the role of diabetes in the development of osteoarthritis (OA) are sparse. METHODS: OA patterns were studied in 809 patients with knee or hip joint replacement due to OA. NIDDM was defined by a history of physician diagnosed diabetes or use of antihyperglycemics. RESULTS: Patients with NIDDM had more often bilateral OA (adjusted odds ratio (OR)=2.2; 95% confidence interval (CI): 0.8-6.4). No association between NIDDM and generalized OA (adjusted OR= 1.0; 95%CI: 0.5-1.9) was observed. CONCLUSIONS: Our results are consistent with the hypothesis that NIDDM might be a potentially important systemic risk factor for knee and hip OA, but chance cannot be ruled out as an alternative explanation.

Aged↗

PubMed2001

Hysterectomy and patterns of osteoarthritis. The Ulm Osteoarthritis Study.

OBJECTIVE: To determine the association between hysterectomy (HE) and patterns of osteoarthritis (OA) METHODS: We performed a large cross-sectional study including 504 female patients admitted for arthroplasty of knee or hip joint. Patients with OA were categorized as having bilateral or generalized OA (GOA) according to the presence of radiographic OA in the contralateral or different finger joints. Odds ratios (OR) and their 95% confidence intervals (CI) for the association between HE and OA patterns were estimated adjusting for potential confounders. RESULTS: Hysterectomy (HE) was reported by 24.9 percent of the patients. Bilateral OA was present in 86.2 percent and GOA was present in 33.3 percent of the patients. HE was not associated with bilateral OA (adjusted OR=0.9; 95% CI: 0.5-1.8) but with a lower prevalence of GOA (adjusted OR=0.6; CI: 0.3-0.99). CONCLUSION: In contrast to earlier studies our results suggest that HE might be a marker for a reduced risk for a generalized pattern of OA.

Age Distribution↗