Prevalence and risk factors for knee osteoarthritis in elderly Japanese men and women

doi:10.1007/s00776-008-1254-2

Journal of Orthopaedic Science

Volume 13, Issue 5, September 2008, Pages 413-418

https://doi.org/10.1007/s00776-008-1254-2 Get rights and content

Abstract

Background

The aims of the present study were to examine the prevalence and risk factors for knee osteoarthritis in elderly Japanese men and women.

Methods

We examined 598 of the 1513 inhabitants of Miyagawa village aged ≥ 65 years (393 women, 205 men). Baseline data, obtained with standard questionnaires, included information on age, past history, sports activity, working, knee pain, smoking, and intakes of alcohol and milk. Bone mineral density of the forearm was measured using dual energy X-ray absorptiometry. Anteroposterior radiographs of both knees were graded for osteoarthritis using the Kellgren-Lawrence grading system. Definite osteoarthritis was defined as a grade of 2 or higher. We used logistic regression analysis by the stepwise method to determine the risk factors for radiographic knee osteoarthritis.

Results

The prevalence of definite radiographic knee osteoarthritis was 30.0% overall: 17.7% in men and 36.5% in women. The prevalence of symptomatic knee osteoarthritis was 21.2% overall: 10.7% in men and 26.7% in women. There were significant differences in the risk of radiographic knee osteoarthritis with body mass index (BMI), sex, age, and bone mineral density (BMD).

Conclusions

The prevalence of definite radiographic knee osteoarthritis was 30.0% and that of symptomatic knee osteoarthritis was 21.2%. We found that higher BMI, female sex, older age, and higher BMD were significantly associated with an increased risk for radiographic knee osteoarthritis.

References (28)

V.K. Srikanth et al.
A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis
Osteoarthritis Cartilage
(2005)
D.T. Felson et al.
Understanding the relationship between body weight and osteoarthritis
Baillieres Clin Rheumatol
(1997)
T. Ushiyama et al.
Expression of genes for estrogen receptors alpha and beta in human articular chondrocytes
Osteoarthritis Cartilage
(1999)
J. Iwamoto et al.
Forearm bone mineral density in postmenopausal women with osteoarthritis of the knee
J Orthop Sci
(2002)
N. Yoshimura et al.
Risk factors for knee osteoarthritis in Japanese women: heavy weight, previous joint injuries, and occupational activities
J Rheumatol
(2004)
D.J. Hart et al.
Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women: the Chingford Study
Arthritis Rheum
(1999)
D.J. Hart et al.
Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women: the Chingford Study
Arthritis Rheum
(1999)
J. Hernborg et al.
Age and sex incidence of osteophytes in the knee joint
Acta Orthop Scand
(1973)
H. Burger et al.
Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age; the Rotterdam Study
Arthritis Rheum
(1996)
J. Dequeker et al.
Inverse relationship osteoarthritis-osteoporosis: what is the evidence? What are the consequences?
Br J Rheumatol
(1996)

M.T. Hannan et al.

Bone mineral density and knee osteoarthritis in elderly men and women; the Framingham Study

Arthritis Rheum

(1993)

M.C. Hochberg et al.

Upper extremity bone mass and osteoarthritis of the knees: data from the Baltimore Longitudinal Study of Aging

J Bone Miner Res

(1995)

M. Terauchi et al.

The influence of osteoporosis on varus osteoarthritis of the knee

J Bone Joint Surg Br

(1998)

J.S. Lawrence et al.

Atlas of standard radiographs of arthritis

Cited by (52)

Quantifying walking ability in Japanese patients with knee osteoarthritis: Standard values derived from a multicenter study
2018, Journal of Orthopaedic Science
Citation Excerpt :
We first examined the factors affecting walking ability, and then stratified patients based on dichotomized values of such factors in order to determine the standard values for the 5mWT and TUGT outcomes in knee OA patients scheduled for TKA. Factors previously reported to affect walking ability in patients with knee OA include sex, advanced age, obesity, disease severity, and pain [17–20]. Laterality and previous history of contralateral surgery may also have an influence on walking ability.
We aimed to determine useful parameters for quantifying walking ability in patients with knee osteoarthritis.
This study included 621 Japanese patients with knee osteoarthritis scheduled to undergo total knee arthroplasty at any of 14 participating hospitals. Sex, age, body mass index, osteoarthritis severity (Kellgren–Lawrence grade), laterality, prior contralateral surgery, and pain were analyzed for their influence on walking ability, which was evaluated in terms of the 5-m walk test and the Timed Up and Go test outcomes during preoperative hospitalization. Patients were stratified based on dichotomized values of the independent influencing factors of walking ability, and the standard values for parameters describing walking ability were obtained.
Multiple regression analysis revealed that sex, age, and Kellgren–Lawrence grade were factors influencing walking ability (5-m walk test and Timed Up and Go test outcomes). Therefore, the patients were stratified by sex, age, and Kellgren–Lawrence grade. The standard values (median values) for walking time on the 5-m walk test among patients aged 60–74/75–89 years were: 3.90/4.64 vs. 4.27/5.12 s for men vs. women with Kellgren–Lawrence grade III; 4.26/5.60 vs. 4.80/6.05 s for men vs. women with Kellgren–Lawrence grade IV. Regarding walking speed on the 5-m test, the standard values were: 1.28/1.08 vs. 1.17/0.98 m/s for men vs. women with Kellgren–Lawrence grade III; 1.17/0.89 vs. 1.04/0.83 m/s for men vs. women with Kellgren–Lawrence grade IV. Finally, the standard values for time on the Timed Up and Go test were: 8.52/10.30 vs. 9.30/11.74 s for men vs. women with Kellgren–Lawrence grade III; 9.40/12.90 vs. 10.05/13.20 s for men vs. women with Kellgren–Lawrence grade IV.
The standard values reported in this study can be used to quantify walking ability decline in patients with knee osteoarthritis and to aid in the decision to consider total knee arthroplasty.
Effects of lateral wedge insole application on medial compartment knee osteoarthritis severity evaluated by ultrasound
2017, Knee
Citation Excerpt :
In the present study, no statistical significance regarding the correlation of the ΔMME LWI with other factors such as BMI, FTA, and KOOS was shown. Increased body weight has been indicated as a risk factor for the progression of knee OA [35,36]. On the other hand, some studies reported the association between meniscus position and BMI and indicated that a higher BMI does not necessarily lead to meniscus extrusion [9,37].
It is known that a lateral wedge insole (LWI) decreases medial loading stress in the knee. Medial meniscus pathology, such as a degenerative tear or a root tear, leading to malfunction and medial meniscus extrusion (MME), is a critical condition that leads to severe osteoarthritis (OA). However, the effect of LWI on MME is still unknown. The objective of this study was to investigate the effect of LWI use on MME in knee OA using ultrasonography.
Thirty-one knees from 18 patients with knee OA diagnosed radiographically were allocated to the OA group (mean age, 73.6 years; sex M:F, 2:16). Twenty-two knees from 11 volunteers without knee OA were also enrolled as an age-matched control group. MME was evaluated using ultrasonography with the patients in three positions: supine, standing without LWI, and standing with LWI.
In both groups, the mean values of the MME increased significantly when patients were in the standing position compared to the supine position. In the OA group, MME significantly decreased with LWI use. There was no significant difference in MME between use and non-use of an LWI in the control group.
The LWI could significantly decrease MME in patients with knee OA.
Association between smoking and risk of knee osteoarthritis: a systematic review and meta-analysis
2017, Osteoarthritis and Cartilage
Citation Excerpt :
After review of the titles and abstracts, 568 articles were excluded and 99 were considered of interest; full text of these 99 articles was obtained for detailed evaluation. After evaluation, 61 of the 99 articles were excluded and 38 articles were included in the meta-analysis12–15,25–58 (Fig. 1). The 38 independent observational studies included in this meta-analysis were published between 1988 and 2016 and included a total of 481,744 individuals.
To investigate the association between smoking and the risk for knee osteoarthritis (OA).
Cohort, case–control, and cross-sectional studies were obtained from the Medline, Embase, and Web of Science databases. Estimates were calculated using a random-effects model. Subgroup analyses and meta-regression models were performed to investigate potential sources of heterogeneity. We further analyzed the dose–response relationship between cigarette consumption and risk of knee OA.
Thirty-eight independent observational studies that included 481,744 participants were analyzed. Those who had ever smoked had a significantly decreased risk of developing knee OA relative to those who had never smoked (RR = 0.80; 95% CI 0.73–0.88). This was unaffected by study design, and the pooled relative risks (RRs) were 0.79 (95% CI, 0.65–0.96), 0.71 (95% CI, 0.61–0.84) and 0.83 (95% CI, 0.73–0.94) for cohort, case–control, and cross-sectional studies, respectively. Analysis of subgroups stratified by gender reduced the heterogeneity from moderate to low in both males and females. The lower risk for developing knee OA was more apparent in male smokers (RR = 0.69; 95% CI 0.58–0.80) than female smokers (RR = 0.89; 95% CI 0.77–1.02) and dose–response analysis showed a linear decrease in knee OA with increased cigarette consumption.
We found an inverse association between cigarette smoking and risk of knee OA, irrespective of study design. This association was more apparent in males. However, we have not demonstrated a causal relationship between smoking and OA, and further investigations are needed.
The relationship between the 25-question Geriatric Locomotive Function Scale and osteoporosis, knee osteoarthritis, and physical performance
2015, Sports Orthopaedics and Traumatology
Locomotive syndrome (LS) is a condition of impaired mobility that is common in individuals with musculoskeletal disease who are at high risk of requiring nursing care. The “25-question Geriatric Locomotive Function Scale” (GLFS-25) was developed to help clinicians detect LS. The purpose of this study is to examine the relationship between the GLFS-25 score and knee osteoarthritis (KOA), osteoporosis (OP), and fall-related physical function in participants of a rural Japanese cohort study (Miyagawa study).
We examined 219 participants (>65 years old) of the 8^th Miyagawa study in 2011. All of the participants completed Kaigo Hoken and GLFS-25 questionnaires and underwent radiography of both knees for KOA, dual energy X-ray absorptiometry for OP, and physical function tests. We classified the participants with a GLFS-25 > 16 points into the LS group (versus the non-LS group).
The LS group had more participants with KOA and OP as well as those who required nursing care by Kaigo Hoken than the non-LS group. Subjects in the LS group had worse physical function than those in the non-LS group.
The GLFS-25 questionnaire is considered a useful instrument because it accurately reflects KOA, OP, Kaigo Hoken nursing care need, and physical function.
Das Bewegungssyndrom (Locomotive Syndrom, LS) bezeichnet einen Zustand von Menschen mit Erkrankungen des Bewegungsapparates, bei denen ein erhöhtes Risiko zukünftiger Pflegebedürftigkeit besteht.
Die „25-Fragen-Funktionsskala zum geriatrischen Bewegungssyndrom„ (25-question Geriatric Locomotive Function Scale, GLFS-25) wurde mit dem Zweck entwickelt, LS zu definieren. Das Ziel dieser Studie ist es, die Beziehung zwischen GLFS-25 und Kniegelenkarthrose und Osteoporose, welche häufig die Ursache für LS sind, im Hinblick auf Pflege- oder Hilfsbedürftigkeit zu untersuchen. Die Untersuchung wurde in Form einer Kohorten-Studie (Miyagawa-Studie) in ländlichen Gebieten in Japan durchgeführt.
Es wurden 219 Teilnehmer (> 65 Jahre alt) der 8. Miyagawa-Studie von 2011 untersucht. Alle Teilnehmer beantworteten die Fragen der GLFS-25 sowie zu ihrer Pflegeversicherung (Kaigo Hoken). Beide Knie wurden auf Kniegelenkarthrose sowie mit Dualenergie-Röntgenabsorptionsmessung auf Osteoporose untersucht und die Funktionen des Bewegungsapparates wurden getestet. Teilnehmer mit GLFS-25 >16 Punkten wurden als LS definiert. Die Teilnehmer wurden in zwei Gruppen geteilt: mit LS und ohne LS.
Im Ergebnis hatte die Gruppe mit LS häufiger Kniegelenkarthrose, Osteoporose und den höheren Einstufungsgrad in der Pflegeversicherung als die Gruppe ohne LS. Außerdem waren die physischen Funktionen der Gruppe mit LS schlechter als die der Gruppe ohne LS.
Die 25-Fragen-Funktionsskala zum geriatrischen Bewegungssyndrom kann als ein effektives, leicht anzuwendendes Instrument betrachtet werden, da sie sowohl Kniegelenkarthrose und Osteoporose als auch Pflegeversicherungsstufe und physische Funktionen berücksichtigt.
Prevalence of clinical and radiological osteoarthritis in knee, hip, and hand in an urban adult population of Mexico City
2020, Reumatologia Clinica
Citation Excerpt :
Other studies that have found similar prevalences to those reported by our research group,20 using only radiological criteria for knee OA include Hochberg in the US 30.4%,21 Odding in the Netherlands 24%,22 Shiozaki in Japan 21.9%,23 and Khang in China, 34.1%.24 Employing only clinical criteria for knee OA, Sudo in Japan found prevalence to be 21.2%,25 and Kim in Korea, 24.2%.26 Utilizing only radiological criteria to diagnose hip OA, Odding in the Netherlands reported prevalence at 15.2%,22 Cvijetiae in Croatia 23%,27 and Quintana, using clinical criteria, found a prevalence of 7.4% in Spain.28
Osteoarthritis (OA) is the most prevalent articular disease worldwide, and its prevalence is highly variable depending on the classification criteria, population studied, and/or affected joints considered. Reporting epidemiologic data about clinical and radiological OA prevalence in Mexico has not been done before.
A descriptive cross-sectional study was carried out with participants of Mexico City, and included both men and women above 40 years of age. All participants were evaluated with radiological and clinical criteria for OA.
Two hundred and four individuals participated in the study: 80 men (39.2%) and 124 women (60.8%). The average age was 57.4 ± 10.9 years. Using clinical criteria alone, 36 participants were found to have hand OA (17.6%; 95% CI, 13–23.4), 37 with hip OA (18.1%; 95% CI 13.4–24), and 40 with knee OA (19.6%; 95% CI 14.7–25.6). When radiological criteria were used, 51 individuals were reported as having hand OA (25%; 95% CI 19.5–31), 54 with hip OA (26.5%; 95% CI 20.8–32.9), and 52 with knee OA (25.5%; 95% CI 20–31.8). When clinical criteria were used and then corroborated with radiological criteria, the prevalence was 28 individuals with hand OA (13.7%; 95% CI 9.6–19), 31 with hip OA (15.1%; 95% CI 10.9–20.7), and 36 with knee OA 36 (17.6%; 95% CI 12.2–26.2).
The prevalences found in this study are greater than those found in other studies in Mexico that only report clinical criteria.
La osteoartritis (OA) es la enfermedad articular más prevalente a nivel mundial; la prevalencia reportada es muy variable ya que depende de los criterios de clasificación, la población estudiada y/o las articulaciones afectadas. Previamente no se habían reportado datos epidemiológicos sobre la prevalencia clínica y radiológica de la OA en México.
Se realizó un estudio descriptivo y transversal, se incluyeron participantes de cualquier sexo mayores de 40 años de la Ciudad de México, todos ellos fueron evaluados con criterios radiológicos y clínicos para la OA.
Se analizaron 204 individuos, 80 varones (39,2%) y 124 mujeres (60,8%). La edad promedio fue de 57,4 ± 10,9 años. Usando solo criterios clínicos, 36 participantes tuvieron OA de mano (17,6%, IC 95%, 13–23,4), 37 con OA de cadera (18,1%, IC 95% 13,4–24) y 40 con OA de rodilla (19,6% IC 95% 14,7–25,6). Cuando se utilizaron los criterios radiológicos, se informó que 51 individuos tenían OA de mano (25%: IC 95% 19,5–31), 54 con OA de cadera (26,5% IC 95% 20,8–32,9) y 52 con OA de rodilla (25,5%; IC 95% 20–31,8). Al utilizar criterios clínicos y luego corroborados por criterios radiológicos, la prevalencia fue de 28 individuos con OA de mano (13,7% IC 95% 9,6–19), 31 con OA de cadera (15,1% IC 95% 10,9–20,7) y 36 con OA de rodilla 36 (17,6%; IC 95% 12,2–26,2).
Las prevalencias encontradas en este estudio son mayores a las encontradas en otros estudios en México que solo reportan criterios clínicos.
Finding the Goldilocks Zone of Mechanical Loading: A Comprehensive Review of Mechanical Loading in the Prevention and Treatment of Knee Osteoarthritis
2024, Bioengineering

View all citing articles on Scopus

View full text

Original articlePrevalence and risk factors for knee osteoarthritis in elderly Japanese men and women

Abstract

Background

Methods

Results

Conclusions

Osteoarthritis Cartilage

Baillieres Clin Rheumatol

Osteoarthritis Cartilage

J Orthop Sci

Risk factors for knee osteoarthritis in Japanese women: heavy weight, previous joint injuries, and occupational activities

J Rheumatol

Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women: the Chingford Study

Arthritis Rheum

Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women: the Chingford Study

Arthritis Rheum

Age and sex incidence of osteophytes in the knee joint

Acta Orthop Scand

Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age; the Rotterdam Study

Arthritis Rheum

Inverse relationship osteoarthritis-osteoporosis: what is the evidence? What are the consequences?

Br J Rheumatol

Bone mineral density and knee osteoarthritis in elderly men and women; the Framingham Study

Arthritis Rheum

Upper extremity bone mass and osteoarthritis of the knees: data from the Baltimore Longitudinal Study of Aging

J Bone Miner Res

The influence of osteoporosis on varus osteoarthritis of the knee

J Bone Joint Surg Br

Atlas of standard radiographs of arthritis

Original article
Prevalence and risk factors for knee osteoarthritis in elderly Japanese men and women