Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints
- Daniel Prieto-Alhambra1,2,3,4,
- Andrew Judge1,3,
- M Kassim Javaid1,3,
- Cyrus Cooper1,3,
- Adolfo Diez-Perez4,
- Nigel K Arden1,3
- 1Oxford NIHR Musculoskeletal BRU, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- 2GREMPAL Research Group, IDIAP Jordi Gol Primary Care Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- 3MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- 4URFOA-IMIM and RETICEF, Parc Salut Mar & Instituto de Salud Carlos III-FEDER, Barcelona, Spain
- Correspondence to Dr Daniel Prieto-Alhambra, Musculoskeletal Epidemiology Group, The Botnar Research Centre, Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK;
- Accepted 12 May 2013
- Published Online First 6 June 2013
Objectives Data on the incidence of symptomatic osteoarthritis (OA) are scarce. We estimated incidence of clinical hip, knee and hand OA, and studied the effect of prevalent OA on joint-specific incident OA.
Methods SIDIAP contains primary care records for>5 million people from Catalonia (Spain). Participants aged ≥40 years with an incident diagnosis of knee, hip or hand OA between 2006 and 2010 were identified using International Classification of Diseases (ICD)-10 codes. Incidence rates and female-to-male rate ratios (RRs) for each joint site were calculated. Age, gender and body mass index-adjusted HR for future joint-specific OA according to prevalent OA at other sites were estimated using Cox regression.
Results 3 266 826 participants were studied for a median of 4.45 years. Knee and hip OA rates increased continuously with age, and female-to-male RRs were highest at age 70–75 years. In contrast, female hand OA risk peaked at age 60–64 years, and corresponding female-to-male RR was highest at age 50–55 years.
Adjusted HR for prevalent knee OA on risk of hip OA was 1.35 (99% CI 1.28 to 1.43); prevalent hip OA on incident knee OA: HR 1.15 (1.08 to 1.23). Prevalent hand OA predicted incident knee and hip OA: HR 1.20 (1.14 to 1.26) and 1.23 (1.13 to 1.34), respectively.
Conclusions The effect of age is greatest in the elderly for knee and hip OA, but around the menopause for hand OA. OA clusters within individuals, with higher risk of incident knee and hip disease from prevalent lower limb and hand OA.