IOSR Journal of Dental and Medical Sciences (JDMS)

ISSN: 2279-0853, ISBN: 2279-0861. Volume 2, Issue 5 (Nov.- Dec. 2012), PP 08-10
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Risk factors of Osteoarthritis Knee A Cross-sectional study

Pushpa S Patil1, Umesh R Dixit2, Chidendra M Shettar3
1, 2
Department of Community Medicine, 3Department of Orthopaedics, SDM College of Medical Sciences and
Hospital,Dharwad, India

Abstract: A hospital based cross sectional study was carried out in a tertiary care centre to study the risk
factors of Osteoarthritis of Knee among patients attending Orthopaedics OPD. All patients aged between 40
and 65 years were included in the study. A total of 102 patients for a period of four months were studied. Nearly
two thirds of our study subjects were women. OA increased with age and BMI. Risk factors like family history,
history of knee injury and occupational knee bending were seen in only few of our study subjects. There is need
to spread awareness among people to adopt preventive measures at an earlier age along with healthy lifestyle
to reduce the body weight and hence the risk of OA.
Keywords: Age, BMI, Osteoarthritis, occupational knee bending, risk factors,.

I. Introduction
Osteoarthritis (OA) is a chronic degenerative joint disease and is the commonest form of arthritis. It
progresses slowly with usual signs and symptoms being pain, enlarged and deformed joints as well as limitation
of the range of motion. It is also a leading cause of disability affecting 60-70% of the population older than 60
years. It usually affects the hand and large weight bearing joints, often the knee and the hip1.
The worldwide prevalence estimate for symptomatic OA is 9.6% among men and 18% among women 2.
It is the fourth leading cause of year lived with disability (YLD). It accounts for the decrease in activities of
daily living (ADL) in elderly dependent population in the community3.
Indisputably the risk factors in high risk population include female gender, old age, overweight, history
of previous injuries or surgeries on the knee4, 5, 6. Among females, the prevalence of OA is said to increase
during menopausal age. Many studies have shown that loss of oestrogen at the time of menopause increases the
womens risk of getting osteoarthritis7. Although OA occurs all over the world, the prevalence and the pattern
of the disease vary depending on the geographical distribution which in turn can provide valuable clues about
the potential etiological factors. A hospital based study was carried out with a purpose to assess the socio-
demographic and risk factors of OA among the study population.

II. Materials and Methods:

A hospital based cross sectional study was carried out for a period of four months from July 2012 to
October 2012 at SDM College of Medical Sciences and Hospital, Dharwad. All patients in the age group of 40-
65 years and confirmed both clinically and radiologically for OA attending SDM Orthopaedics OPD were
included in the study. Patients below the age of 40 years and above the age of 65 years were not included in the
study. Also the patients with recent trauma with considerable tissue damage, patients with terminal conditions,
alcohol abuse, psychiatric disorder and previous/ planned arthroplasty were excluded from the study. After
obtaining informed consent, study subjects were interviewed and data was recorded on a standardized pre-
designed and a pre-tested questionnaire. Questionnaire focussed on Socio-demographic profile and assessment
of possible risk factors (age, family history, obesity, physical activity, occupational knee bending and knee
injury). Measurements like height, weight and body mass index (BMI) were recorded. The results were analysed
using SPSS software version 20. Chi square test, ratios and proportions were used.

III. Results
A total of one hundred and two subjects were enrolled in the study of whom 35 (34.3%) were males
and 67 (65.7%) were females. Table no. 1 shows that majority of them, 26 (25.5%) were in the age group of 55
59 years. Only a quarter of study subjects 26 (25.5%) had positive family history of OA. Of these, men
(37.1%) had higher percentage of family history compared to women (19.4%). This difference was not
statistically significant (2 = 3.81 at df=1 and p>0.05).Most of the women 55 (82.1%) were homemakers while
majority of the men in the study 17 (48.6%) were unskilled workers. Most of the study subjects 96 (94.2%)
belonged to Hindu religion. 76 (74.5%) of the study subjects were literates. Most of them belonged to nuclear
type of family 65 (63.7%).
Table 2 shows the distribution of risk factors among study subjects. It was observed that majority of the
study subjects, 57 (55.9%) were obese. Obesity was more common amongst women 45 (67.2%) compared to

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 Risk factors of Osteoarthritis Knee A Cross-sectional study

men 18 (51.4%), who were more overweight. This difference was statistically significant at p<0.01 (2 = 11.38
at df=2).
Table 2 also shows that more than four fifth of the study subjects 82 (80.4%) were involved in
moderate level of physical activity. It was observed in the study that occupational knee bending was more
commonly present in men. This risk factor was present in two out of every five men while it was observed in
less than a quarter of women. This difference was however not statistically significant.
History of knee injury is another important risk factor that was studied. It was seen that most of our
study subjects 85 (83.3%) had no history of knee injury. The history of knee injury was almost equally
distributed among both the sexes.

Table no. 1: Socio-demographic profile of study subjects:

Age (in years) Sex Total
Male Female
No (%) No (%) No (%)
40 44 1 (2.9) 5 (7.5) 6 (5.9)
45 49 4 (11.4) 13 (19.4) 17 (16.7)
50 54 8 (22.9) 12 (17.9) 20 (19.6)
55 59 9 (25.7) 17 (25.4) 26 (25.5)
>/= 60 13 (37.1) 20 (29.9) 33 (32.4)
Family history
Present 13 (37.1) 13 (19.4) 26 (25.5)
Absent 22 (62.9) 54 (80.6) 76 (74.5)

Table 2: Distribution of Risk Factors vs. Sex of study subjects

Body Mass Index Sex Total

Male Female
No (%) No (%) No (%)
Underweight 1 (2.9) 0 1 (1.0)
Normal 4 (11.4) 8 (11.9) 12 (11.8)
Overweight 18 (51.4) 14 (20.9) 32 (31.4)
Obese 12 (34.3) 45 (67.2) 57 (55.9)
Physical Activity
Sedentary 4 (11.5) 15 (22.3) 19 (18.6)
Moderate 31 (88.6) 51 (76.1) 82 (80.4)
Strenuous 0 1 (1.5) 1 (1.0)
Occupational Knee Bending
Present 14 (40.0) 16 (23.9) 30 (29.4)
Absent 21 (60.0) 51 (76.1) 72 (70.6)
Knee Injury
Present 5 (14.3) 12 (17.9) 17 (16.7)
Absent 30 (85.7) 55 (82.1) 85 (83.3)

IV. Discussion
In our study it was observed that the percentage of people with osteoarthritis increased as the age
increases. This observation is similar to that in a study done in south Delhi 8 and at other places9, 10.
OA was more in women compared to men in our study (65.7% vs. 34.3% respectively). This difference
can be possibly due to the lack of physical activity, mobility, social issues especially in our region and higher
prevalence of obesity among women in general. A study done by Iqbal MN et al also observed that OA was
more in women (74%) compared to men (26%)11. A similar observation was also made in a study done by
Sharma MK et al10 which was 70.1% vs 41.6%.
In our study it was observed that men were less in number compared to women for any given age
group. However this observation differs from that made in a study by Dr David T Felson et al. This study
observed that before age of 50, men were affected more while after age of 50 years women were more
affected12.
Family history of OA was present in a few 26/102 (25.5%) of our study subjects. A study by Mangat G
et al also reported presence of family history in only few of their patients 41/300 (13.7%)13.

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 Risk factors of Osteoarthritis Knee A Cross-sectional study

Majority of our study subjects 57/ 102 (55.9%) were obese. Mean BMI was 28.44 8.68 kgm-2. Mean
BMI was also found to be high 28.09 plus-minus 4.43 in a study done by Mangat G et al13. Also a study done by
Iqbal MN et al observed that mean BMI was high 29.43 7.84 in OA cases11.
In our study most men had more occupational knee bending compared to women (40% vs. 23.9%) This
can be due to the fact that most of the women in our study were homemakers. A study done by Cooper C et al
found that occupational knee bending is a positive risk factor for development of OA knee. The odds of getting
OA with increased occupational knee bending were significantly more than for those who had no knee bending.
The odds ratio varied from 1.2 to 6.9 for different types of knee bending14.
In our study, history of knee injury preceding the OA was found in only 17/102 (16.7%) study subjects.
This was in contrast to the observations made by Trivedi et al who observed that knee injury was present in
63.3% in patients with OA. Their study also found that the odds of getting OA after knee injury are 4.54 times
than without any knee injury15.

V. Conclusion:
OA is a major public health problem especially in people after the age of 50 years. In our study we
observed that there is relationship between age, sex and BMI with OA. Family history, occupational knee
bending and history of knee injury were less prevalent in our study. The number of people with OA increased as
the age increased; hence it is likely that if preventive measures can be taken in the earlier age groups OA can be
prevented.

Acknowledgements:
We would like to thank the doctors and the patients who cooperated with the data collection. We also
thank our principal, Dr. J V Chowti for giving us an opportunity to carry out the study.

References:
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