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(REFERENCES)Tj
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[(1.)-875.1 (Hart DJ, Doyle DV)128.8 (, Spector )17.7 (TD. Incidence and risk factors for )]TJ
1.675 -1.25 Td
(radiographic knee osteoarthritis in middle-aged women: the)Tj
0 -1.25 TD
[(Chingford Study)64.8 (. )54.8 (Arthritis Rheum 1999;42:17-24.)]TJ
-1.675 -1.25 Td
[(2.)-875.1 (Felson DT)73.9 (. Epidemiology of osteoarthritis. In: Brandt KD, Doherty)]TJ
1.675 -1.25 Td
(M, Lohmander LS, editors. Osteoarthritis. Oxford, UK: Oxford)Tj
T*
(University Press; 2003:9-16.)Tj
-1.675 -1.25 Td
[(3.)-875.1 (Kujala UM, Kettunen J, Paananen H, et al. Knee osteoarthritis in)]TJ
1.675 -1.25 Td
[(former runners, soccer players, weight lifters and shooters. )54.8 (Arthritis)]TJ
0 Tc T*
(Rheum 1995;38:539-46.)Tj
-0.00011 Tc -1.675 -1.25 Td
[(4.)-875.1 (Spector )17.7 (TD, Harris P)91.7 (A, Hart DJ, et al. Risk of osteoarthritis )]TJ
1.675 -1.25 Td
[(associated with long-term weight-bearing sports. )54.8 (Arthritis Rheum)]TJ
0 Tc 0 Tw T*
(1996;39:988-95.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(5.)-875.1 (Puranen J, )54.8 (Ala-Ketola L, Peltokallio P)110.7 (, et al. Running and primary)]TJ
1.675 -1.25 Td
(osteoarthritis of the hip. BMJ 1975;1:424-5.)Tj
-1.675 -1.25 Td
[(6.)-875.1 (Marti B, Knobloch M, )17.7 (T)69.9 (schopp )54.8 (A, )54.8 (Armin J, Howald H. Is excessive)]TJ
1.675 -1.25 Td
(running predictive of degenerative hip disease? Controlled study of)Tj
T*
(former elite athletes. BMJ 1989;299:91-3.)Tj
-1.675 -1.25 Td
[(7.)-875.1 (V)59.8 (ingard E. )17.7 (The epidemiology of osteoarthritis in the peripheral)]TJ
1.675 -1.25 Td
(joints: Session 4: Risk factors \321 physical activity: osteoarthrosis o\
f)Tj
T*
[(the knee and physical load from occupation. )54.8 (Ann Rheum Dis)]TJ
0 Tc 0 Tw T*
(1996;55:677-9.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(8.)-875.1 (V)59.8 (ingard E, )54.8 (Alfredsson L, Goldie I, Hogstedt C. Sports and)]TJ
1.675 -1.25 Td
[(osteoarthrosis of the hip. )54.8 (An epidemiologic study)64.8 (. )54.8 (Am J Sports Med)]TJ
0 Tc 0 Tw T*
(1993;21:195-200.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(9.)-875.1 (Kujala UM, Kaprio J, Sarna S. Osteoarthritis of weight bearing)]TJ
1.675 -1.25 Td
(joints of lower limbs in former elite male athletes. BMJ )Tj
0 Tc 0 Tw T*
(1994;308:231-4.)Tj
-0.00011 Tc 0.02499 Tw -2.175 -1.25 Td
[(10.)-875.1 (McDermott M, Freyne P)110.7 (. Osteoarthrosis in runners with knee pain.)]TJ
2.175 -1.25 Td
(Br J Sports Med 1983;17:84-7.)Tj
-2.1381 -1.25 Td
[(1)36.8 (1)-0.1 (.)-875.1 (Cheng )36.8 (Y)128.9 (, Macera CA, Davis DR, )54.8 (Ainsworth BE, )17.7 (T)35 (roped PJ, Blair)]TJ
2.1381 -1.25 Td
(SN. Physical activity and self-reported, physician-diagnosed)Tj
T*
(osteoarthritis: Is physical activity a risk factor? J Clin Epidemiol)Tj
0 Tc 0 Tw T*
(2000;43:315-22.)Tj
-0.00011 Tc 0.02499 Tw -2.175 -1.25 Td
[(12.)-875.1 (Lane NE, Buckwalter JA. Exercise and osteoarthritis. Curr Opin)]TJ
2.175 -1.25 Td
[(Rheumatol 1999;1)36.8 (1:413-6.)]TJ
-2.175 -1.25 Td
[(13.)-875.1 (McGibbon CA, Krebs DE, Mann R)54.8 (W)91.9 (. In vivo hip pressures during)]TJ
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[(cane and load-carrying gait. )54.8 (Arthritis Care Res 1997;10:300-7.)]TJ
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[(14.)-875.1 (W)79.9 (alker PS, Hajek JV)128.8 (. )17.7 (The load-bearing area in the knee joint. )]TJ
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(J Biomech 1972;5:581-9.)Tj
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[(15.)-875.1 (Coggon D, Croft P)110.7 (, Kellingray S, Barrett D, McLaren M, Cooper C.)]TJ
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(Occupational physical activities and osteoarthritis of the knee.)Tj
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(Arthritis Rheum 2000;43:1443-9.)Tj
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(knee in the First National Health and Nutrition Examination Survey)Tj
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[(\(NHANES I\). )54.8 (Am J Epidemiol 1988;128:179-89.)]TJ
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[(17.)-875.1 (T)69.9 (epper S, Hochber)17.7 (g MC. Factors associated with hip osteoarthritis:)]TJ
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(data from the First National Health and Nutrition Examination)Tj
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[(Survey \(NHANES-1\). )54.8 (Am J Epidemiol 1993;137:1081-8.)]TJ
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[(18.)-875.1 (Nevitt MC, Lane NE, Scott JC, et al. Relationship of hip)]TJ
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[(osteoarthritis to obesity and bone mineral density in older )54.8 (American)]TJ
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(women: preliminary results from the Study of Osteoporotic)Tj
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[(Fractures. )54.8 (Acta Orthop Scand 1993;64 Suppl:2-5. )]TJ
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