Summary
Objective
To examine the association between body mass index (BMI) trajectories from early adulthood
to late midlife and risk of total knee arthroplasty (TKA) for osteoarthritis.
Methods
24,368 participants from the Melbourne Collaborative Cohort Study with weight collected
during 1990–1994, 1995–1998, and 2003–2007, recalled weight at age 18–21 years, and
height measured during 1990–1994 were included. Incident TKA from 2003 to 2007 to
December 2018 was determined by linking cohort records to the National Joint Replacement
Registry.
Results
Using group-based trajectory modelling, six distinct trajectories (TR) of BMI from
early adulthood (age 18–21 years) to late midlife (approximately 62 years) were identified:
lower normal to normal BMI (TR1; 19.7% population), normal BMI to borderline overweight
(TR2; 36.7%), normal BMI to overweight (TR3; 26.8%), overweight to borderline obese
(TR4; 3.5%), normal BMI to class 1 obesity (TR5; 10.1%), overweight to class 2 obesity
(TR6; 3.2%). Over 12.4 years, 1,328 (5.4%) had TKA. The hazard ratios for TKA increased
in all TR compared to TR1 [from TR2: 2.03 (95% CI 1.64–2.52) to TR6: 8.59 (6.44–11.46)].
28.4% of TKA could be prevented if individuals followed the trajectory one lower,
an average weight reduction of 8–12 kg from early adulthood to late midlife, saving
$AUS 373 million/year. Most reduction would occur in TR2 (population attributable
fraction 37.9%, 95% CI 26.7–47.3%) and TR3 (26.8%, 20.0–31.2%).
Conclusions
Prevention of weight gain from young adulthood to late midlife in order to reduce
overweight/obesity has the potential to significantly reduce the cost and burden of
TKA.
Keywords
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Article info
Publication history
Published online: December 12, 2022
Accepted:
November 29,
2022
Received:
August 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
