Risk factors for the development of knee osteoarthritis across the lifespan : A systematic review and meta-analysis
(2025) In Osteoarthritis and Cartilage 33(10). p.1162-1179- Abstract
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.... (More)
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.
(Less)
- author
- Duong, Vicky
; Abdel Shaheed, Christina
; 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.
LU
; 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
and Cooper, Cyrus
(Less) - organization
- publishing date
- 2025-10
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cohort studies, Knee osteoarthritis, Risk factors
- in
- Osteoarthritis and Cartilage
- volume
- 33
- issue
- 10
- pages
- 18 pages
- publisher
- W.B. Saunders
- external identifiers
-
- scopus:105004432464
- pmid:40174718
- ISSN
- 1063-4584
- DOI
- 10.1016/j.joca.2025.03.003
- language
- English
- LU publication?
- yes
- id
- b3f444df-3a93-466f-a1db-fe02714ae51b
- date added to LUP
- 2025-09-29 12:36:04
- date last changed
- 2025-10-14 11:54:42
@article{b3f444df-3a93-466f-a1db-fe02714ae51b,
abstract = {{<p>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.</p>}},
author = {{Duong, Vicky and Abdel Shaheed, Christina and Ferreira, Manuela L. and Narayan, Sujita W. and Venkatesha, Venkatesha and Hunter, David J. and Zhu, Jimmy and Atukorala, Inoshi and Kobayashi, Sarah and Goh, Siew Li and Briggs, Andrew M. and Cross, Marita and Espinosa-Morales, Rolando and Fu, Kai and Guillemin, Francis and Keefe, Francis and Stefan Lohmander, L. and March, Lyn and Milne, George J. and Mei, Yifang and Mobasheri, Ali and Namane, Mosedi and Peat, George and Risberg, May Arna and Sharma, Saurab and Sit, Regina and Telles, Rosa Weiss and Zhang, Yuqing and Cooper, Cyrus}},
issn = {{1063-4584}},
keywords = {{Cohort studies; Knee osteoarthritis; Risk factors}},
language = {{eng}},
number = {{10}},
pages = {{1162--1179}},
publisher = {{W.B. Saunders}},
series = {{Osteoarthritis and Cartilage}},
title = {{Risk factors for the development of knee osteoarthritis across the lifespan : A systematic review and meta-analysis}},
url = {{http://dx.doi.org/10.1016/j.joca.2025.03.003}},
doi = {{10.1016/j.joca.2025.03.003}},
volume = {{33}},
year = {{2025}},
}