Citation

Richmond SA, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA. J. Orthop. Sports Phys. Ther. 2013; 43(8): 515-B19.

Copyright

(Copyright © 2013, Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association)

DOI

10.2519/jospt.2013.4796

PMID

23756344

Abstract

STUDY DESIGN: Systematic review with Meta-analysis. OBJECTIVES: Identify risk factors for osteoarthritis (OA) of the knee, hip and ankle including joint injury, sport, physical activity, overweight/obesity, and occupational activity in all age groups. BACKGROUND: OA is a significant health problem worldwide, affecting up to 10% of men and 18% of women over 60 years. There has not been a comprehensive review examining modifiable physical risk factors associated with the onset of OA. This evidence is important to inform the physiotherapy management of individuals following onset of OA. METHODS: Twelve electronic databases were systematically reviewed. Studies selected met the following criteria; a) original data, b) joint injury, sport activity, physical activity, overweight/obesity, and/or occupational activity investigated as risk factors, c) outcome included OA (hip, knee, and/or ankle), and d) analytic component of study design. The data extracted included study design, years follow-up, study population, OA definition, risk factors, and results (effect estimates reported or calculated where available). The quality of evidence was assessed based on a modified version of the Downs and Black checklist. RESULTS: Joint injury, obesity, and occupational activity were associated with an increased risk of OA of the knee and hip. Sport and physical activity produced inconsistent findings. Joint injury was identified as a significant risk factor for knee OA (Combined Odds Ratio (OR) = 3.8, 95% CI; 2.0- 7.2) hip OA (Combined OR= 5.0, 95% CI; 1.4 - 18.2) and previous meniscectomy with or without ACL injury (Combined OR= 7.4, 95% CI; 4.0 - 13.7). There is a paucity of research examining risk factors associated with ankle OA, where this review identified only 2 studies with this outcome. CONCLUSIONS: Joint injury, obesity, and occupational activity are associated with an increased risk of knee and hip OA. Some findings remain inconclusive including levels of physical activity and sport-specificity in individuals that do not suffer an injury. Early identification of individuals at risk for OA provides an opportunity for physiotherapy management or other interventions to modify risk-related behaviour. There is a need in the literature for additional high quality studies, such as prospective cohort studies that minimize potential bias, in examining the relationship with physical risk factors and OA.J Orthop Sports Phys Ther, Epub 11 June 2013. doi:10.2519/jospt.2013.4796.

Language: en