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Osteoarthritis - Risk Factors

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of the most common form of arthritis.

Alternative Names

Arthritis - osteoarthritis

Risk Factors:

In the U.S., osteoarthritis affects about 27 million Americans age 25 years and older.

Age

Osteoarthritis can affect people of any age, but it is much more common in older people. It rarely occurs in people younger than age 40.

Gender

In people younger than 45, osteoarthritis occurs more frequently in men. After age 45, it develops more often in women. Some research suggests that women may also experience greater muscle and joint pain, in general, than men.

Obesity

Obesity, defined as being 20% over one's healthy weight, places people (particularly women) at increased risk for osteoarthritis. It also worsens osteoarthritis once deterioration begins. This higher risk is due to increased weight on the joints.

Work and Leisure Factors

Because injuries can trigger the disease process, people whose work or leisure activities place them at risk for muscle and joint injuries may face a higher risk for osteoarthritis later on.

Workers at Higher Risk. Certain occupations with repeated stressful motions (such as squatting or kneeling with heavy lifting) can contribute to the deterioration of cartilage. People with jobs that require kneeling or squatting for more than an hour a day are at high risk for knee osteoarthritis. Jobs that involve lifting, climbing stairs, or walking also pose some risk.

Exercise. There has been some question about the role of strenuous exercise in osteoarthritis. Sports that definitely pose a higher risk for osteoarthritis have repetitive or direct joint impact (such as football), joint twisting, or both (baseball pitching, soccer). The increase in exercise intensity by young girls, including increased incidence of significant injuries, has raised concerns that we may see an increase in the incidence of future osteoarthritis.

Regular and moderate exercise, however, is important for everyone and does not increase the risk for osteoarthritis. Recreational weight-bearing exercise (walking, jogging), done by middle-aged and elderly people, neither prevents osteoarthritis nor increases risk. Furthermore, many factors associated with a sedentary life (such as muscle weakness and obesity) are associated with a higher risk for osteoarthritis.

Physical Deformities

Some people are born with anatomical abnormalities, such as mismatched surfaces on the joints, which could be damaged over time. Legs of unequal length or skewed feet can cause jerky movement and may cause osteoarthritis.

Resources

www.rheumatology.org -- American College of Rheumatology
www.arthritis.org -- Arthritis Foundation
www.niams.nih.gov -- National Institute of Arthritis and Musculoskeletal and Skin Diseases
www.aaos.org -- American Academy of Orthopaedic Surgeons

References

Brouwer RW, Raaij van TM, Bierma-Zeinstra SM, et al. Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev. 2007;(3):CD004019.

Cepeda MS, Camargo F, et al. Tramadol for osteoarthritis: a systematic review and metaanalysis. J Rheumatol. 2007;34(3):543-555.

Das A, Neher JO, Safranek S. Clinical inquiries. Do hyaluronic acid injections relieve OA knee pain? J Fam Pract. 2009 May;58(5):281c-e.

Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD004376.

Gregory PJ, Sperry M, Wilson AF. Dietary supplements for osteoarthritis. Am Fam Physician. 2008;77(2):177-184.

Gutierrez GP. Managing osteoarthritis: what's best for your patient? J Fam Pract. 2008 Oct;57(10):644-50.

Hamel MB, Toth M, Legedza A, et al. Joint replacement surgery in elderly patients with severe osteoarthritis of the hip or knee: decision making, postoperative recovery, and clinical outcomes. Arch Intern Med. 2008;168(13):1430-1440.

Harris ED Jr., Barnett GD, Budd RC, et al., eds. Kelley's Textbook of Rheumatology, 7th ed. Philadelphia, PA: Saunders; 2005.

Hernández-Molina G, Reichenbach S, Zhang B, Lavalley M, Felson DT. Effect of therapeutic exercise for hip osteoarthritis pain: results of a meta-analysis. Arthritis Rheum. 2008 Sep 15;59(9):1221-8.

Hunter DJ. In the clinic: Osteoarthritis. Ann Intern Med 2007;147(3):ITC8-1-ITC8-16.

Lane NE. Clinical practice. Osteoarthritis of the hip. N Engl J Med. 2007;357(14): 1413-1421.

Lange AK, Vanwanseele B, Fiatarone Singh MA. Strength training for treatment of osteoarthritis of the knee: a systematic review. Arthritis Rheum. 2008 Oct 15;59(10):1488-94.

Laupattarakasem W, Laopaiboon M, Laupattarakasem P, et al. Arthroscopic debridement for knee osteoarthritis. Cochrane Database Syst Rev. 2008;(1):CD005118.

Leopold SS. Minimally invasive total knee arthroplasty for osteoarthritis. N Engl J Med. 2009 Apr 23;360(17):1749-58.

Manheimer E, Linde K, Lao L, et al. Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med. 2007;146(12):868-877.

Rozendaal RM, Koes BW, van Osch GJ, et al. Effect of glucosamine sulfate on hip osteoarthritis: a randomized trial. Ann Intern Med. 2008;148(4):268-277.

Sun BH, Wu CW, Kalunian KC. New developments in osteoarthritis. Rheum Dis Clin N Am. 2007;(33):-135-148.

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(2):137-162.

Reviewed last on: 6/23/2009
Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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