Ambulatory activity is protective for hip replacement due to fracture and due to osteoarthritis but has detrimental effects on knee replacement due to osteoarthritis: a population-based prospective cohort study — ASN Events
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Ambulatory activity is protective for hip replacement due to fracture and due to osteoarthritis but has detrimental effects on knee replacement due to osteoarthritis: a population-based prospective cohort study (#109)

Ishanka Munugoda 1 , Karen Wills 1 , Flavia Cicuttini 2 , Stephen Graves 3 , Michelle Lorimer 4 , Graeme Jones 1 , Michele Callisaya 1 , Dawn Aitken 1
  1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  2. Department of Epidemiology and Preventive Medicine, Monash University Medical School, Melbourne, Victoria, Australia
  3. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, South Australia, Australia
  4. South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia

Objective

To examine the association between ambulatory activity (AA), body composition measures and hip or knee joint replacement (JR).

 

Methods

At baseline, 1082 community-dwelling older adults aged 50 – 80 years were studied. AA was measured objectively using pedometer and body composition by dual-energy x-ray absorptiometry. The incidence of JR diagnosis was determined by data linkage to the Australian Orthopaedic Association National Joint Replacement Registry. Generalized estimating equations were used to estimate the association between AA, body composition measures and JR, adjusting for age, sex, x-ray disease severity, and pain.

 

Results

Over 13 years of follow-up, 12 participants had a hip replacement (HR) due to fracture and 50 a HR due to osteoarthritis while 74 reported a knee replacement (KR) due to osteoarthritis. Higher AA was associated with a lower risk of HR due to fracture (RR 0.74, 95% CI 0.59, 0.93) and HR due to osteoarthritis (RR 0.90, 95% CI 0.81, 0.99) but with a higher risk of KR due to osteoarthritis (RR 1.09, 95% CI 1.01, 1.16). There was no relationship between obesity measures and HR due to fracture but higher BMI, fat mass, trunk fat mass and waist circumference were associated with higher risk of KR due to osteoarthritis (RR 1.07, 95% CI 1.03, 1.12; RR 1.04, 95% CI 1.02, 1.07; RR 1.04, 95% CI 1.02, 1.07; RR 1.03, 95% CI 1.01, 1.05, respectively).

 

Conclusions

An objective measure of AA was associated with a reduced risk of HR due to fracture and HR due to osteoarthritis but it was related with an increased risk of KR due to osteoarthritis. Worse body composition profiles were detrimental against KR due to osteoarthritis, but not for HR. Altogether this suggests different causal pathways for osteoporotic fracture and osteoarthritis on each site with regard to habitual activity and obesity.