Top Takeaways About Osteoarthritis
People With OA Have a Higher Risk of a Variety of Comorbidities
What’s New A study published in April 2022 in the Annals of Family Medicine, presented by lead researcher Anne Kamps, a doctoral candidate at Erasmus University Medical Center in the Netherlands, looked at whether patients with OA were more apt to suffer from comorbidities when one or more diseases coexisted with the primary disease. People with knee OA showed positive associations with obesity, fibromyalgia, polymyalgia, drug abuse, and rheumatoid arthritis, among others conditions. People with hip OA showed positive associations with polymyalgia, fibromyalgia, spinal disc herniation, thromboembolic disease, alcohol abuse, and more. The research found that patients who already had OA also had a higher risk of comorbidity afterward than those of the same age and sex without a prior OA diagnosis. However, the study wasn’t designed to establish whether those connections were causal or coincidental. Research Details The research team conducted a cohort study, analyzing data from the Integrated Primary Care Information database, an electronic health records database of medical records from 2.5 million patients in the Netherlands. The study population consisted of patients ages 18 and older at risk of developing OA and 58 preselected long-term comorbidities. Why It Matters People with OA have a higher risk of being diagnosed with many comorbidities, mostly other musculoskeletal and pain conditions, but also conditions in completely different organ systems. “This suggests that treating doctors or paramedics of patients with OA should consider the risk of development of these conditions that are highly associated. A timely diagnosis can sometimes prevent conditions from getting worse, such as in cases of drug or alcohol abuse or sleeping disorders,” says Kamps. She adds that “for researchers, our study provides many interesting new starting points for future causal research, to better understand if these diseases that occur more often after OA are caused by OA or maybe have the same risk or mediating factors.”
2 Studies on Lowering BMI Show Slowing of OA Incidence and Progression in Knees, Risk of Knee Replacements
What’s New Sultana Monira Hussain, PhD, senior research fellow, Chronic Disease and Ageing, at Monash University in Australia, presented research that looked at the connection between total knee arthroplasties (TKA) — aka total knee replacements — due to OA and BMI. The team discovered that while the underlying mechanisms involved in the relationship are complex and not completely understood, a continuous increase in biomechanical loading and metabolic inflammation associated with excess adipose tissue may play a major role in disease incidence and progression. Another study, led by Zubeyir Salis, a doctoral candidate at the Centre for Big Data Research in Health, part of the University of New South Wales in Australia, also suggested that a decrease in BMI is associated with less narrowing of the joint space on the medial but not lateral side of the knee. The medial side of the knee joint (the side where the legs meet) is the weight-bearing side of the knee joint, and that is likely why it is affected by weight changes, while the lateral side of the knee joint (which is on the outside of the knee joint, and bears less weight than the medial side) is not affected. Research Details First Study The research team collected data on TKA from the Australian Orthopaedic Association National Joint Replacement Registry. All TKAs were due to OA. In this current study, participants were identified according to their BMI from early adulthood (ages 18 to 21) to mid and late adulthood (ages 49 to 76). The team identified six BMI trajectories (TR): TR1 (19.7 percent of participants) had a lower normal to normal BMI, TR2 (36.7 percent of participants) had a BMI that increased from normal to borderline overweight, TR3 (26.8 percent of participants) started with a normal BMI and became overweight gradually, TR4 (3.5 percent of participants) started overweight and became borderline obese, TR5 (10.1 percent of participants) started at a normal BMI and became class 1 obese, and TR6 (3.2 percent of participants) started at overweight and became class 2 obese. Second Study The research team analyzed data from a total of 8,824 participants from the United States and the Netherlands, who were followed for four to five years. The team concluded that the loss of one BMI unit corresponded to a 4.76 percent reduction in the odds of incidence and progression of overall structural defects of knee osteoarthritis over four to five years. A five-unit decrease in BMI, which is an amount that can lead to a reduction in BMI category (e.g., from overweight to normal), reduced the odds of incidence and progression by 21.65 percent over four to five years. Why It Matters “Our results suggest that maintaining BMI within a normal range or changing the BMI trajectory toward the normal range would significantly reduce the burden of TKA for OA. Also, our study suggests that prevention of weight gain from young adulthood to midlife in the population, to reduce overweight and obesity, may have a major impact on the burden of severe knee OA and associated healthcare costs,” says Dr. Hussain. “Weight loss has been shown to be effective at reducing pain and improving quality of life in people with knee osteoarthritis. In this study, we now show that people with overweight or obesity — and potentially also those of normal weight — may benefit from a decrease in BMI to prevent, delay, or slow the structural defects in knee osteoarthritis,” says Salis. Daniel Hernandez, MD, director of medical affairs and Hispanic outreach at CreakyJoints, who was not part of any of the studies, adds that this is “more evidence that healthy weight loss through healthy living and eating is important in a disease like OA. The less weight bearing on the knees, the less risk of structural damage was found.”
