Summary
Objective
To describe the effect of knee symptoms and radiographic osteoarthritis (ROA) on the
risk of falls, recurrent falls, and fractures.
Design
Participants from the Osteoarthritis Initiative were classified as having ‘no’, ‘unilateral’
or ‘bilateral’ knee symptoms (≥19 on a 0–96 Western Ontario and McMaster Universities
Osteoarthritis Index) and ROA (Kellgren–Lawrence grade ≥2) for each visit. Self-reported
falls and fractures in the past 12 months were extracted at baseline and follow-up
visits until month 96. Recurrent falls were defined as having ≥2 falls in the past
12 months. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated using
mixed-effects complementary log–log regression.
Results
Of 4465 participants, 3145 (70%), 1681 (38%), and 806 (18%) experienced at least one
fall, recurrent fall, and fracture, respectively, over 96 months. Compared to participants
without symptomatic knee, unilateral and bilateral knee symptoms were associated with
a 17% increased risk of falls and a 36–46% increased risk of recurrent falls, and
bilateral knee symptoms increased the risk of fractures (HR 1.45, 95%CI 1.17 to 1.81).
Compared to participants with no ROA in either knee, bilateral ROA was associated
with a reduced risk of falls (HR 0.87, 95%CI 0.77 to 0.99) and fractures (HR 0.78,
95%CI 0.64 to 0.96). No statistically significant interactions between knee symptoms
and ROA were observed.
Conclusions
This large population-based study showed that knee symptoms but not ROA increased
the risk of falls, recurrent falls, and fractures, and that adults with bilateral
ROA may have a lower risk of falls and fractures.
Keywords
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Article info
Publication history
Published online: November 30, 2021
Accepted:
November 24,
2021
Received:
August 6,
2021
Identification
Copyright
© 2021 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
