Clinical studyTotal hip replacement due to osteoarthritis: the importance of age, obesity, and other modifiable risk factors☆
Section snippets
Methods
The Nurses’ Health Study is a prospective cohort of 121,701 female nurses who were aged 30 to 55 years in 1976. Information on diseases, lifestyle, and health practices is collected from the subjects via biennial questionnaires, with a response rate of greater than 90% for each questionnaire.
We used self-reported total hip replacement on the 1990 to 1996 questionnaires as a surrogate for clinically severe primary hip osteoarthritis. We mailed a supplementary questionnaire to all participants
Results
Of the 1435 women who reported hip replacement from 1990 to 1996, 1142 (80%) responded to the supplemental questionnaire to confirm the diagnosis of primary osteoarthritis. Of these, 871 women (76%) reported hip replacement due to osteoarthritis. We excluded 137 women who had surgery before 1990 and 166 who had cancer or cardiovascular disease, leaving 568 cases for analysis.
Women with higher body mass index were less likely to take postmenopausal hormones, exercise, drink alcohol, or smoke
Discussion
In a cohort of more than 93,000 female nurses, we found that high body mass index was a risk factor for total hip replacement due to osteoarthritis. In addition, a substantial risk associated with body mass index was established early in life; even modest increments in body mass index at age 18 years were associated with a greater risk of future hip replacement. Unlike some studies 17, 20, 26, 27, 28, 29, 30, we found no association between hip replacement due to osteoarthritis and
Acknowledgements
We wish to thank the dedicated nurses in the Nurses’ Health Study who have now participated in the study for more than 25 years. We also thank Julie Herbstman for her assistance, Drs. Piran Aliabadi and John Carrino for reviewing the radiographs, and Dr. Jeffrey Katz for reviewing the manuscript.
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2019, Journal of BiomechanicsCitation Excerpt :Indeed, aberrant loading of joints has been identified as an important risk factor of the progression of knee osteoarthritis (Waller et al., 2011) due to a number of factors, including varus-valgus misalignment and anterior cruciate ligament rupture (Andriacchi et al., 2004; Brouwer et al., 2007; Sharma et al., 2001). Even though this is still a contentious topic (Felson, 2000; Reijman et al., 2006), excessive joint loading as a result of obesity has been related to joint degeneration as reported for hip osteoarthritis (Cooper et al., 1998), total hip replacement (Karlson et al., 2003) and tibiofemoral misalignment (Felson et al., 2004). Unloading of joints has been proposed as a conservative treatment to osteoarthritis progression (Lafeber et al., 2006) and interventions focus on weight loss and gait retraining (Shull et al., 2013).
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Supported by grants AR42630, CA87969, AR36308, and K08 AR 02074-1 from the National Institutes of Health, Bethesda, Maryland. Dr. Karlson is the recipient of an Arthritis Foundation Investigator Award. Dr. Mandl is a recipient of an Arthritis Foundation Physician Scientist Award.
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Deceased. Formerly from the University of Munich, School of Medicine.