Sex differences in the association between body mass index and total hip or knee joint replacement resulting from osteoarthritis

May 28, 2008Annals of the rheumatic diseases

How body weight relates to hip or knee joint replacement for osteoarthritis differs between men and women

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Abstract

The odds of undergoing total knee replacement (TKR) are 5.3 times higher for obese men compared to normal-weight individuals.

Obese men have a significantly increased risk of TKR, with an odds ratio (OR) of 5.3.
Overweight men are associated with a 1.7 times higher likelihood of requiring TKR.
Women who are obese also show a higher risk for TKR, with an OR of 4.0.
The association between body mass index (BMI) and total hip replacement (THR) is weaker, with no significant increase for overweight or obese women.
The findings suggest a stronger link between high BMI and TKR than with THR, particularly in men.

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OBJECTIVE: To examine the association between body mass index (BMI) and osteoarthritis (OA) leading to total hip (THR) or knee (TKR) joint replacement.

METHODS: Case-control study design. All patients still living in Iceland who had had a THR or TKR resulting from OA before the end of 2002 were invited to participate. First-degree relatives of participating patients served as controls. A total of 1473 patients (872 women) and 1103 controls (599 women), all born between 1910 and 1939 and who had answered a questionnaire including questions about height and weight, were analysed. A randomly selected sample, representative of the Icelandic population, was used as a secondary control group.

RESULTS: The OR, adjusted for age, occupation and presence of hand OA, for having a THR was 1.1 (95% CI 0.9 to 1.5) for overweight men and 1.7 (95% CI 1.0 to 2.9) for obese men. The OR for having a TKR was 1.7 (95% CI 1.1 to 2.6) for overweight men and 5.3 (95% CI 2.8 to 10.1) for obese men. The OR for having a THR was 1.0 (95% CI 0.8 to 1.3) for overweight women and 1.0 (95% CI 0.6 to 1.5) for obese women. The OR for having a TKR was 1.6 (95% CI 1.1 to 2.2) for overweight women and 4.0 (95% CI 2.6 to 6.1) for obese women.

CONCLUSION: This study supports a positive association between high BMI and TKR in both sexes, but for THR the association with BMI seems to be weaker, and possibly negligible for women.

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Sex differences in the association between body mass index and total hip or knee joint replacement resulting from osteoarthritis

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