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Osteoarthritis of the Knee and Hip after Joint Injury FREE

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Copyright ©2004 by the American College of Physicians


Ann Intern Med. 2000;133(5):I-16. doi:10.7326/0003-4819-133-5-200009050-00001
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What is the problem and what is known about it so far?

In osteoarthritis, the cartilage of joints degenerates, making joint movement limited and painful. People with osteoarthritis report a history of joint injury more often than people without osteoarthritis. It is possible, however, that people with osteoarthritis may not actually have had previous joint injuries more often, but may simply remember them better than people without joint disease. The best way to determine whether injuries actually lead to later osteoarthritis is to record knee or hip injuries in a group of people at the time that they happen. You can then see if those who have injuries develop osteoarthritis later in life more often than those who do not.

Why did the researchers do this particular study?

To see whether knee or hip injuries that occur early in adult life are truly associated with osteoarthritis later on.

Who was studied?

A total of 1321 persons who graduated from the Johns Hopkins School of Medicine in Baltimore, Maryland, between 1948 and 1964.

How was the study done?

At graduation, study participants underwent a history and examination, including assessment of diseases of the muscles, bones, and joints; a history of joint injuries; levels of physical activity; and height and weight. Participants then completed yearly questionnaires to update their health status, including development of new joint injuries and osteoarthritis. In 1995, surviving participants who had previously reported osteoarthritis completed a detailed questionnaire about their arthritis.

What did the researchers find?

The participants were 91% male and 97% white. Over an average follow-up of 36 years, 141 participants reported joint injuries (111 knee injuries alone, 16 hip injuries alone, and 14 injuries of both). Of these 141 injuries, 64 had occurred before graduation and the remainder occurred later on. Of the 1321 participants, 96 developed osteoarthritis (64 knee, 27 hip, and 5 both). By age 65, 13.9% of participants with previous joint injuries in young adulthood had developed osteoarthritis compared with only 6% of those without previous knee or hip injuries. Persons with previous knee injuries were five times more likely to develop knee osteoarthritis than persons without them. Persons with previous hip injuries were over three times more likely to develop hip osteoarthritis than persons without them.

What were the limitations of the study?

These findings might not apply to persons other than white men. The researchers relied on participants' reports of osteoarthritis (verified by symptoms and x-ray findings) rather than checking medical records or examining the patients to confirm the diagnosis. The study also does not provide information about the possible relation between injury and arthritis in joints other than the knee and hip.

What are the implications of the study?

Men who suffer knee and hip injuries early in adult life are at greater risk for osteoarthritis of these joints later on than are men who do not have such injuries.

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician.

The summary below is from the full report titled “Joint Injury in Young Adults and Risk for Subsequent Knee and Hip Osteoarthritis.” It is in the 5 September 2000 issue of Annals of Internal Medicine (volume 133, pages 321-328). The authors are AC Gelber, MC Hochberg, LA Mead, N-Y Wang, FM Wigley, and MJ Klag.

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician.

The summary below is from the full report titled “Joint Injury in Young Adults and Risk for Subsequent Knee and Hip Osteoarthritis.” It is in the 5 September 2000 issue of Annals of Internal Medicine (volume 133, pages 321-328). The authors are AC Gelber, MC Hochberg, LA Mead, N-Y Wang, FM Wigley, and MJ Klag.

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