Risk factors for the development of knee osteoarthritis across the lifespan: a systematic review and meta-analysis
Duong, Vicky; Shaheed, Christina Abdel; Ferreira, Manuela L; Narayan, Sujita W; Venkatesha, Venkatesha; Hunter, David J; Zhu, Jimmy; Atukorala, Inoshi; Kobayashi, Sarah; Goh, Siew Li; Briggs, Andrew M; Cross, Marita; Espinosa-Morales, Rolando; Fu, Kai; Guillemin, Francis; Keefe, Francis; Stefan Lohmander, L; March, Lyn; Milne, George J; Mei, Yifang; Mobasheri, Ali; Namane, Mosedi; Peat, George; Risberg, May Arna; Sharma, Saurab; Sit, Regina; Telles, Rosa Weiss; Zhang, Yuqing; Cooper, Cyrus (2025-03-31)
Elsevier
31.03.2025
Vicky Duong, Christina Abdel Shaheed, Manuela L. Ferreira, Sujita W. Narayan, Venkatesha Venkatesha, David J. Hunter, Jimmy Zhu, Inoshi Atukorala, Sarah Kobayashi, Siew Li Goh, Andrew M. Briggs, Marita Cross, Rolando Espinosa-Morales, Kai Fu, Francis Guillemin, Francis Keefe, L. Stefan Lohmander, Lyn March, George J. Milne, Yifang Mei, Ali Mobasheri, Mosedi Namane, George Peat, May Arna Risberg, Saurab Sharma, Regina Sit, Rosa Weiss Telles, Yuqing Zhang, Cyrus Cooper, Risk factors for the development of knee osteoarthritis across the lifespan: A systematic review and meta-analysis, Osteoarthritis and Cartilage, 2025, ISSN 1063-4584, https://doi.org/10.1016/j.joca.2025.03.003
https://creativecommons.org/licenses/by/4.0/
© 2025 The Author(s). Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
https://creativecommons.org/licenses/by/4.0/
© 2025 The Author(s). Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
https://creativecommons.org/licenses/by/4.0/
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202506094248
https://urn.fi/URN:NBN:fi:oulu-202506094248
Tiivistelmä
Summary
Objective:
To identify and quantify risk factors for incident knee osteoarthritis (KOA) across the lifespan.
Methods:
This systematic review and meta-analysis identified eligible studies from seven electronic databases and three registries. Longitudinal cohort studies or randomised controlled trials evaluating participants who developed incident symptomatic and/or radiographic KOA were included. Two independent reviewers completed data screening and extraction. Estimates were pooled using a random effects model and reported as odds ratio (OR), hazard ratio, or risk ratio and corresponding 95% confidence intervals (95% CI). Grading of Recommendations, Assessment, Development and Evaluation was used to determine the certainty of evidence. Population attributable fractions were calculated, including risk factors significantly associated with radiographic KOA based on the pooled meta-analysis and where we could determine communality scores using existing clinical datasets.
Results:
We identified 131 studies evaluating > 150 risk factors. Previous knee injury, older age and high bone mineral density were associated with an increased risk of incident radiographic KOA based on the pooled analysis [OR (95% CI): 2.67 (1.41, 5.05), 1.15 (1.00, 1.33) and 1.82 (1.12, 2.94), respectively], with moderate-to-high certainty. Two risk factors (overweight/obesity and previous knee injury) accounted for 14% of incident radiographic KOA. Other modifiable risk factors, including occupational physical activity, also contribute to radiographic or symptomatic KOA.
Conclusion:
Novel strategies addressing known modifiable risk factors including overweight/obesity, knee injuries and occupational physical activity are needed to reduce overall burden of KOA.
Systematic review registration:
PROSPERO ID: CRD42023391187
Objective:
To identify and quantify risk factors for incident knee osteoarthritis (KOA) across the lifespan.
Methods:
This systematic review and meta-analysis identified eligible studies from seven electronic databases and three registries. Longitudinal cohort studies or randomised controlled trials evaluating participants who developed incident symptomatic and/or radiographic KOA were included. Two independent reviewers completed data screening and extraction. Estimates were pooled using a random effects model and reported as odds ratio (OR), hazard ratio, or risk ratio and corresponding 95% confidence intervals (95% CI). Grading of Recommendations, Assessment, Development and Evaluation was used to determine the certainty of evidence. Population attributable fractions were calculated, including risk factors significantly associated with radiographic KOA based on the pooled meta-analysis and where we could determine communality scores using existing clinical datasets.
Results:
We identified 131 studies evaluating > 150 risk factors. Previous knee injury, older age and high bone mineral density were associated with an increased risk of incident radiographic KOA based on the pooled analysis [OR (95% CI): 2.67 (1.41, 5.05), 1.15 (1.00, 1.33) and 1.82 (1.12, 2.94), respectively], with moderate-to-high certainty. Two risk factors (overweight/obesity and previous knee injury) accounted for 14% of incident radiographic KOA. Other modifiable risk factors, including occupational physical activity, also contribute to radiographic or symptomatic KOA.
Conclusion:
Novel strategies addressing known modifiable risk factors including overweight/obesity, knee injuries and occupational physical activity are needed to reduce overall burden of KOA.
Systematic review registration:
PROSPERO ID: CRD42023391187
Kokoelmat
- Avoin saatavuus [38618]
Ellei muuten mainita, aineiston lisenssi on https://creativecommons.org/licenses/by/4.0/