Ann Rheum Dis 1999;58:151-155 ( March )

Extended reports

Osteoarthrosis of the knee in men and women in association with overweight, smoking, and hormone therapy Hélène Sandmark,^{a b} Christer Hogstedt,^{a b c} Stefan Lewold,^d Eva Vingård^{a b c}

^a Department of Occupational Health, Karolinska Hospital, SE-171 76 Stockholm, Sweden, ^b Department of Public Health Sciences, Division of Occupational Health, Karolinska Institute, Stockholm, Sweden, ^c Department for Work and Health, National Institute for Working Life, Solna, Sweden, ^d Department of Orthopaedics, Lund University Hospital, Lund, Sweden

Correspondence to: Dr H Sandmark.

Accepted for publication 23 December 1998

OBJECTIVESThe aim was to examine the relation between osteoarthrosis of the knee leading to prosthetic surgery among men and women and overweight, smoking, and hormone therapy.
METHODSA case-referent study was performed with a study base of all men and women, born 1921-1938, living in 14 counties in Sweden during 1991-95. The cases (n=625) were identified through the Swedish Knee Arthroplasty Register. The referents (n=548) were randomly selected through the central population register from the same counties. Detailed information on general health status, height, weight, smoking habits, medication, use of hormones, specific physical loads from occupation and housework, and sports activities was collected by a telephone interview and a postal questionnaire. The cases were classified in terms of high, medium or low/non-exposure to the factors studied, according to the distribution of variables among the referents.
RESULTSWomen with high body mass index (BMI) at the age of 40 had a relative risk of 9.2 (95%CI 5.3, 16.0) of developing severe knee osteoarthrosis later in life, and for men at the same age the relative risk was 3.9 (95%CI 2.3, 6.4). Smokers were less likely to develop severe knee osteoarthrosis compared with non-smokers. Oestrogen therapy for women over 50 showed an increased relative risk of 1.8 (95%CI 1.2, 2.6), while use of oral contraceptives did not influence the risk .
CONCLUSIONOverweight is a risk factor for knee osteoarthrosis leading to prosthetic surgery in men and women, with the strongest relation for women. Oestrogen therapy after 50 increased the relative risk, while smoking decreased it.

Keywords: body mass index; life style factors; oestrogen therapy; relative risk

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© 1999 by Annals of the Rheumatic Diseases
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