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J Rheumatol. 2010 Jun;37(6):1260-5. doi: 10.3899/jrheum.091154. Epub 2010 Apr 15.

Quantifying the association of radiographic osteoarthritis in knee or hip joints with other knees or hips: the Johnston County Osteoarthritis Project.

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  • 1Arthritis Research Centre of Canada, 895 West 10th Avenue, Vancouver, British Columbia V5Z 1L7, Canada. esayre@arthritisresearch.ca



To quantify the association of radiographic osteoarthritis (ROA) in one knee or hip joint with other knee or hip joints.


We analyzed baseline data from the Johnston County Osteoarthritis Project (n = 3068). We fit 4 models for left/right knee/hip. The Kellgren-Lawrence (KL) radiographic grade severity scale was KL 0/1 (no/questionable ROA), 2 (mild ROA), or 3/4 (moderate/severe ROA). We estimated associations between KL grade in contralateral joints and other joint sites (e.g., worst hip in knee models), adjusting for sex, race/ethnicity (African American/white), age, and measured body mass index, using cumulative odds logistic regression models. Interactions were investigated: race/ethnicity by sex; race/ethnicity and sex by the 2 explanatory variables.


Contralateral joint KL grade was strongly associated with KL grade, with OR ranging from 9.2 (95% CI 7.1, 11.9) to 225.0 (95% CI 83.6, 605.7). In the left knee model, the contralateral joint association was stronger among African Americans than whites, but for the other models the associations by race/ethnicity were identical. Models examining other joint sites showed weaker but mostly statistically significant associations (OR 1.4 to 1.8).


We found a strong multivariable-adjusted association between KL grades in contralateral knees and hips, and a modest association with the other joint site (e.g., knees vs hips). These results suggest that diagnosis of ROA in 1 large joint may be a marker for risk of multijoint ROA, and warrant interventions to reduce the incidence or severity of ROA at these other joints.

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