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Ann Intern Med. 2000 Sep 5;133(5):321-8.

Joint injury in young adults and risk for subsequent knee and hip osteoarthritis.

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1
Johns Hopkins University, University of Maryland, and Veterans Affairs Medical Center, Baltimore, USA.

Abstract

BACKGROUND:

Knee and hip injuries have been linked with osteoarthritis in cross-sectional and case-control studies, but few prospective studies have examined the relation between injuries in young adults and risk for later osteoarthritis.

OBJECTIVE:

To prospectively examine the relation between joint injury and incident knee and hip osteoarthritis.

DESIGN:

Prospective cohort study.

SETTING:

Johns Hopkins Precursors Study.

PARTICIPANTS:

1321 former medical students.

MEASUREMENTS:

Injury status at cohort entry was recorded when the mean age of participants was 22 years. Injury during follow-up and incident osteoarthritis were determined by using self-administered questionnaires. Osteoarthritis was confirmed by symptoms and radiographic findings.

RESULTS:

Over a median follow-up of 36 years, 141 participants reported joint injuries (knee alone [n = 111], hip alone [n = 16], or knee and hip [n = 14]) and 96 developed osteoarthritis (knee alone [n = 64], hip alone [n = 27], or knee and hip [n = 5]). The cumulative incidence of knee osteoarthritis by 65 years of age was 13.9% in participants who had a knee injury during adolescence and young adulthood and 6.0% in those who did not (P = 0.0045) (relative risk, 2.95 [95% CI, 1.35 to 6.45]). Joint injury at cohort entry or during follow-up substantially increased the risk for subsequent osteoarthritis at that site (relative risk, 5.17 [CI, 3.07 to 8.71] and 3.50 [CI, 0.84 to 14.69] for knee and hip, respectively). Results were similar for persons with osteoarthritis confirmed by radiographs and symptoms.

CONCLUSIONS:

Young adults with knee injuries are at considerably increased risk for osteoarthritis later in life and should be targeted in the primary prevention of osteoarthritis.

[Indexed for MEDLINE]

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