181 18 Epidemiology, Risk Factors, and Aging of Osteoarthritis
However, after adjusting for other factors, the LLI was moderately associated with knee symptoms and less strongly with hip symptoms. This study, however, implied that LLI might be a modifiable risk factor for therapy of people with knee and hip symptoms [97].
Proprioception is the conscious perception of body position, loading, and movement [98]. Proprioceptive deficits were found to be greater in people with knee OA compared with that in people of similar age without the deficit [99, 100]. A recent 30-month longitudinal follow-up study failed to demonstrate any associations between proprioceptive acuity and development or progression of symptomatic and radiographic OA [101].
Conclusions
Aging is the main risk factor of primary OA, and OA is strongly correlated with aging. Our present understanding of the etiopathogenesis of OA suggests a multifactorial phenom- enon. Others would consider OA as total joint failure owing to changes not only in cartilage, but also in other joint structures such as ligaments, subchondral bone, synovium, and periar- ticular muscle, and even alterations in nerve conductions. New developments in imaging modalities, genetic studies, and its application in the epidemiologic studies will provide new information on the pathogenesis of OA, and further elucidate the role of these and other factors in the development and progression of OA. As these advances progress, classification criteria for OA will most likely change in the future as exem- plified by a recent attempt to reclassify primary OA into three subsets according to their genetic, hormonal, and aging contri- butions [106]. Its usefulness, however, has been criticized [107], owing to the complexity of the disease process along with the numerous confounding variables in most if not all population studies. Indeed, the importance of our understand- ing of the epidemiology of OA, its establishment, and identifi- cation of its risk factors with newer imaging modalities will somehow make future developments in the quest for newer and effective therapeutic interventions, and change the current approach of palliating symptoms of OA into an approach of modifying or possibly halting the disease process.
References
1. Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis Rheum.
2008;58:15–25.
2. Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998;41:578–799.
3. Defrances CJ, Podgornik MN. 2004 National Hospital Discharge Survey. Adv Data. 2006;4:1–19.
4. Kellgren JH, Lawrence JS, editors. The epidemiology of chronic rheumatism, atlas of standard radiographs. Oxford: Blackwell Scientific; 1963.
5. Petersson IF, Boegard T, Saxne T, Silman AJ, Svensson B.
Radiographic osteoarthritis of the knee classified by the Ahlback and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35–54 years with chronic knee pain. Ann Rheum Dis.
1997;56:493–6.
6. Altman RD, Block DA, Dougados M, Hochberg M, Lohmander S, Pavelka K, et al. Measurement of structural progression in osteoar- thritis of the hip: the Barcelona Consensus Group. Osteoarthritis Cartilage. 2004;12:515–24.
7. Reijman M, Hazes JM, Pols HA, Bernsen RM, Koew BW, Bierma- Zeinstra SM. Validity and reliability of three definitions of hip osteoarthritis: cross-sectional and longitudinal approach. Ann Rheum Dis. 2004;63:1427–33.
8. Croft P, Cooper C, Coggon D. Case definition of hip osteoarthritis in epidemiologic studies. J Rheumatol. 1994;21:591–2.
9. Lane NE, Nevitt MC, Genant HK, Hochberg MC. Reliability of new indices of radiographic osteoarthritis of the hand and hip and lumbar disc degeneration. J Rheumatol. 1993;20:1911–8.
Fig. 18.3 Theoretical model demonstrating the relationship between biomechanical stress and aging through its effect on oxidative stress, extracellular matrix changes, and formation of advanced glycation end products (AGE) leading to osteoarthritis (OA). Agingrelated oxidative stress and abnormal biomechanical stress results in increased levels of reactive oxygen species (ROS) in chondrocytes. The increase
in ROS modulates anabolic and catabolic signaling pathways, resulting in increased metalloproteinases and cytokines, and decreased extracellular matrix production and growth factors contributing to OA. Aging results in increased AGE formation that causes increased extracellular matrix stiffness and failure, contributing to the development and progression of OA
183 18 Epidemiology, Risk Factors, and Aging of Osteoarthritis
10. Reijman M, Hazes JM, Koes BW, Verhagen AP, Bierma-Zeinstra SM. Validity, reliability and applicability of seven definitions of hip osteoarthritis used in epidemiological studies: a systematic appraisal. Ann Rheum Dis. 2004;63:226–32.
11. Altman R, Alarcon G, Appelrouth D, Blouch D, Borenstein D, Brandt K, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand.
Arthritis Rheum. 1990;33:1601–10.
12. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee.
Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29:1039–49.
13. Altman R, Alarcón G, Appelrouth D, Bloch D, Borenstein D, Brandt K, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip.
Arthritis Rheum. 1991;34:505–14.
14. Birell F, Lunt M, Macfarlane G, Silman A. Association between pain in the hip region and radiographic changes of osteoarthritis: results from a population based study. Rheumatology. 2005;44:337–41.
15. Christmas C, Cerspo CJ, Franckowiack SC, Bathon JM, Bartlett SJ, Andersen RE. How common is hip pain among older adults?
Results from the Third National Health and Nutrition Examination Survey. J Fam Pract. 2002;4:345–8.
16. Jordan JM, Helmick CG, Renner JB, Luta G, Dragomir AD, Woodard J, et al. Prevalence of hip symptoms and radiographic and symptom- atic hip OA in African American and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol. 2009;36(4):809–15.
17. Hoaglund FR, Oishi CS, Gialamas GG. Extreme variations in racial rates of total hip arthroplasty for primary coxarthrosis: a population- based study in San Francisco. Ann Rheum Dis. 1995;54:107–10.
18. Jordan JM, Hochberg MC, Silman AJ, Smolen JS, Weinblatt MR, Weisman MH. Epidemiology and classification of osteoarthritis.
Rheumatology 4th ed. 2008.
19. Lane NE, Nevitt MC, Hochberg MC, Hung YY, Palermo L. Progression of radiographic hip osteoarthritis over 8 years in a community sam- pleof elderly white women. Arthritis Rheum. 2004;50:1477–86.
20. Mili F, Helmicjk CG, Moriarty DG. Health related quality of life among adults reporting arthritis: analysis of data from the Behavioral Risk Factor Surveillance System, US, 1996–99. J Rheumatol. 2003;50:120–5.
21. Jordan JM, Helmick CG, Renner JB, Luta G, Dragomir AD, Woodard J, et al. Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol. 2007;34:172–80.
22. Morgan B, Mullick S, Harper WM, Finlay DB. An audit of knee radiographs performed for general practitioners. Br J Radiol.
1997;70:256–60.
23. Lanyon P, O’Reilly S, Jones A, Doherty M. Radiographic assess- ment of symptomatic knee osteoarthritis in the community: defini- tion and normal joint space. Ann Rheum Dis. 1998;57:595–601.
24. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meehan RF. The prevalence of knee osteoarthritis in the elderly: the Framingham Osteoarthritis Study. Arthritis Rheum. 1987;30:914–8.
25. Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the third National Health and Nutrition Examination Survey 1991–1994.
J Rheumatol. 2006;33:2271–9.
26. Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence off arthritis and other rheumatic conditions in the United States Part II. Arthritis Rheum.
2008;58:26–35.
27. Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, et al. The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med. 2001;134:541–9.
28. Hill CT, Gale DG, Chaisson CE, Skinner K, Kazis L, Gale ME, et al.
Knee effusions, popliteal cysts and synovial thickening: association with knee pain in osteoarthritis. J Rheumatol. 2001;28:1330–7.
29. Ding C, Cicuttini F, Scott F, Cooley H, Jones G. Association between age and knee structural change: a cross sectional MRI based study. Ann Rheum Dis. 2005;64:549–55.
30. Bejjani FJ, Landsmer JMF. Biomechanics of the hand. In: Nordin M, Frankel VH, editors. Basic biomechanics of the musculoskel- etal system. Philadelphia: Lea & Febiger; 1989. p. 275–304.
31. Kalichman L, Hernandez-Molina G. Hand osteoarthritis: an epidemiologic perspective. Seminar Arthritis Rheum. 2009;39:
465–76.
32. Kellgren JH, Moore R. Generalized osteoarthritis and Heberden’s nodes. BMJ. 1952;1:181–7.
33. Zhang Y, Niu J, KellyHayes M, Chaisson CE, Aliabadi P, Felson DT. Prevalence of symptomatic hand osteoarthritis and its impact on functional status among elderly: the Framingham Study. Am J Epidemiol. 2002;156:1021–7.
34. Dahaghin S, Bierma-Zeistra SM, Ginai AZ, Pols HA, Hazes JM, Koes BW. Prevalence and pattern of radiographic hand osteoar- thritis and association with pain and disability (the Rotterdam study). Ann Rheum Dis. 2005;64(5):682–7.
35. Brandt KD, Dieppe P, Radin E. Etiopathogenesis of osteoarthritis.
Rheum Dis Clin North Am. 2008;34:531–59.
36. Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, et al. Osteoarthritis: new insights. Part I: the disease and its risk factors. Ann Intern Med. 2000;133(8):635–46.
37. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Rheum Dis Clin North Am. 2008;34:515–29.
38. Swedberg JA, Steinbauer JR. Osteoarthritis. Am Fam Physician.
1992;45:557–68.
39. Braidman IP, Hainey L, Batra G, Selby PL, Saunders PT, Hoyland JA. Localization of estrogen receptor beta protein expression in adult human bone. J Bone Miner Res. 2001;16:214–20.
40. Ushiyama T, Ueyama H, Inoue K, Ohkubo S. Expression of genes for estrogen receptors alpha and beta in human articular chondro- cytes. Osteoarthritis Cartilage. 1999;7:560–6.
41. Liu SH, al-Shaikh R, Panossian V, Yang RS, Nelson SD, Soleiman N. Primary immunolocalization of estrogen and progesterone tar- get cells in the human anterior cruciate ligament. J Orthop Res.
1996;14:526–33.
42. Dietrich W, Haitel A, Holzer G, Huber JC, Kolbus A, Tschugguel W. Estrogen receptorbeta is the predominant estrogen receptor subtype in human synovial. J Soc Gynecol Investig. 2006;13:
512–7.
43. Kahlert S, Grohe C, Karas RH, Lobbert K, Neyses L, Vetter H.
Effects of estrogen on skeletal myoblast growth. Biochem Biophys Res Commun. 1997;232:373–8.
44. Wluka AE, Cicuttini FM, et al. Menopause, estrogens and arthri- tis. Maturitas. 2000;35:83–99.
45. Nevitt MC, Felson DT, Williams EN, Grady D. The effect of estro- gen plus progestin on knee symptoms and related disability in post-menopausal women: the heart and estrogen/progestin replace- ment study, a randomized, double-blind, placebo-controlled trial.
Arthritis Rheum. 2001;44:811–8.
46. Carbone LD, Nevitt MC, Wildy K, Barrow KD, Harris F, Felson D, et al. The relationship of anti-resorptive drug use to structural finding and symptoms of knee osteoarthritis. Arthritis Rheum.
2004;50:3516–25.
47. Wluka AE, Davis SR, Bailey M, Stuckey SL, Cicuttini FM. Users of estrogen replacement therapy have more knee cartilage than non-users. Ann Rheum Dis. 2001;60:332–6.
48. Sniekers YH, Weinans H, Bierma-Zeinstra SM, van Leeuwen JP, van Osch GJ. Animal models for osteoarthritis: the effect of ova- riectomy and estrogen replacement – a systematic approach.
Osteoarthritis Cartilage. 2008;16:533–41.
49. Anderson JJ, Felson DT. Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (NHANES I). Evidence for an association with overweight, race and physical demands of work. Am J Epidemiol. 1988;128:179–89.
50. Hannan MT, Anderson JJ, Pincus T, Felson DT. Educational attainment and osteoarthritis: differential associations with radio- graphic changes and symptomatic reporting. J Clin Epidemiol.
1992;45:139–47.
51. Muirden KD. Community Oriented Program for the Control of Rheumatic Diseases: studies of rheumatic diseases in the develop- ing world. Curr Opin Rheumatol. 2005;17:153–6.
52. Zhang Y, Xu L, Nevitt MC, Aliabadi P, Shindo H, Takemoto T.
Comparison of the prevalence of knee osteoarthritis between elderly Chinese population in Beijing and whites in the United States: the Beijing Osteoarthritis Study. Arthritis Rheum. 2001;44:
2065–71.
53. Stecher RM. Heberden’s nodes: heredity in hypertrophic arthritis of the finger joints. Am J Med Sci. 1941;201:801–9.
54. Spector TD, Cicuttini F, Baker J, Loughlin J, Hart D. Genetic influences on osteoarthritis in women: a twin study. BMJ.
1996;312:940–3.
55. Valdes AM, Spector TD. The contribution of genes to osteoarthri- tis. Med Clin North Am. 2009;93:45–66.
56. Valdes AM, Spector TD. The genetic epidemiology of osteoarthri- tis. Curr Opin Rheumatol. 2010;22:139–43.
57. Kämäräinen OP, Solovieva S, Vehmas T, Luoma K, Leino-Arjas P, Riihimäki H, et al. Aggrecan core protein of a certain length is protective against hand osteoarthritis. Osteoarthritis Cartilage.
2006;14:1075–80.
58. Reginato AM, Olsen BR. The role of structural genes in the patho- genesis of osteoarthritic disorders. Arthritis Res. 2002;4:337–45.
59. Murray RO. The aetiology of primary osteoarthritis of the hip. Br J Radiol. 1965;38:810–24.
60. Stulberg SD, Cooperman DR, Wallensten R. The natural history of Legg–Calve–Perthes disease. J Bone Joint Surg Am. 1981;63:
1095–108.
61. Lane NE, Lin P, Christiansen L, Gore LR, Williams EN, Hochberg MC, et al. Association of mild acetabular dysplasia with an increased risk of incident hip osteoarthritis in elderly white women: the study of osteoporotic fractures. Arthritis Rheum. 2000;43:400–4.
62. Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman B, Aliabadi P, et al. Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham study. Arthritis Rheum. 1997;40:728–33.
63. Schouten JS, van den Ouweland F, Valkenburh HA. A 12 year follow up study in the general population on prognostic factors of cartilage loss in osteoarthritis of the knee. Ann Rheum Dis. 1992;51:832–7.
64. Cooper C, McAlindon T, Snow S, Vines K, Young P, Kirwan J, et al. Mechanical and constitutional risk factors for symptomatic knee osteoarthritis: differences between medial tibiofemoral and patellofemoral disease. J Rheumatol. 1994;21:307–13.
65. Powell A, Teichtahl AJ, Wluka AE, Cicuttini FM. Obesity: a preventable risk factor for large joint osteoarthritis which may act through biomechanical factors. Br J Sports Med. 2005;39:4–5.
66. Spector TD, Hart DJ, Nandra D, Doyle DV, Mackillop N, Gallimore JR, et al. Low-level increases in serum C-reactive protein are pres- ent in early osteoarthritis of the knee and predict progressive dis- ease. Arthritis Rheum. 1997;40:723–7.
67. Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the arthritis, diet and activity promotion trial. Arthritis Rheum. 2004;50:1501–10.
68. Christensen R, Bartels EM, Astrup A, Bliddal H. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a sys- tematic review and meta-analysis. Ann Rheum Dis. 2007;66:433–9.
69. Nevitt MC, Lane NE, Scott JC, Hochberg MC, Pressman AR, Genant HK, et al. Radiographic osteoarthritis of the hip and bone mineral density. The study of osteoporotic fractures research group. Arthritis Rheum. 1995;38:907–16.
70. Hannan MT, Anderson JJ, Zhang Y, Levy D, Felson DT. Bone mineral density and knee osteoarthritis in elderly men and women.
The Framingham study. Arthritis Rheum. 1993;36:1671–80.
71. Zhang Y, Hannan MT, Chaisson CE, McAlindon TE, Evan SR, Aliabadi P, et al. Bone mineral density and risk of incident and progressive radiographic knee osteoarthritis in women: the Framingham Study. J Rheumatol. 2000;27:1032–7.
72. Bingham III CO, Buckland-Wright JC, Garnero P, Cohen SB, Dougadous M, Adami S, et al. Risedronate decreases biochemical markers of cartilage degradation but does not decrease symptoms or slow radiographic progression in patients with medial compart- ment osteoarthritis of the knee. Arthritis Rheum. 2006;54:
3494–507.
73. Bhalla AK, Wojno WC, Goldring MB. Human articular chondro- cytes acquire 1,25-(OH)2 vitamin D3 receptors in culture. Biochim Biophys Acta. 1987;931:26–32.
74. McAlindon TE, Felson DT, Zhang Y, Hannan MT, Aliabadi P, Weissman B, et al. Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among par- ticipants in the Framingham Study. An Intern Med. 1996;125:
353–9.
75. Lane NE, Gore LR, Cummings SR, Hochberg MC, Scott JC, Williams EN, et al. Serum vitamin D levels and incident changes of radio- graphic hip osteoarthritis: a longitudinal study. Study of Osteoporotic Fractures Research Group. Arthritis Rheum. 1999;42:854–60.
76. Rosenthal AK. Calcium crystal deposition and osteoarthritis.
Rheum Dis Clin North Am. 2006;32:401–12.
77. Olmez N, Schumacher Jr HR. Crystal deposition and osteoarthri- tis. Curr Rheumatol Rep. 1999;1:107–11.
78. Ea HK, Liote F. Advances in understanding calciumcontaining crystal disease. Curr Opin Rheumatol. 2009;21:150–7.
79. Lane NE, Michel B, Bjorkengren A, Oehlert J, Shi H, Bloch DA, et al. The risk of osteoarthritis with running and aging: a 5 year longitudinal study. J Rheumatol. 1993;20:461–8.
80. Spector TD, Harris PA, Hart DJ, Cicuttini FM, Nandra D, Etherington J, et al. Risk of osteoarthritis associated with long
term weight-bearing sports: a radiological survey of the hips and knees in female ex-athletes and population controls. Arthritis Rheum. 1996;39:988–95.
81. Lohmander LS, Ostenberg A, Englund M, Roos H. High preva- lence of knee osteoarthritis, pain and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. 2004;50:3145–52.
82. Roos EM, Ostenberg A, Roos H, Ekdahl C, Lohmander LS. Long
term outcome of meniscectomy: symptoms, function and perfor- mance tests in patients with or without radiographic osteoarthritis compared to matched controls. Osteoarthritis Cartilage. 2001;
9:616–24.
83. McAlindon TE, Wilson PW, Aliabadi P, Zhang Y. Recreational physical activity and the risk of radiographic and symptomatic knee osteoarthritis in the elderly: the Framingham study. Am J Med. 1999;106:151–7.
84. Felson DT, Hannan MT, Naimark A, Berkely J, Gordon G, Wilson PW, et al. Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham study. J Rheumatol.
1991;18:1587–92.
85. Holmberg S, Thelin A, Thelin N. Is there an increased risk of knee osteoarthritis among farmers? A population-based case-control study. Int Arch Occup Environ Health. 2004;77:345–50.
86. Lawrence JS. Rheumatism in cotton operatives. Br J Ind Med.
1961;18:270–6.