Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2019

Open Access 01-12-2019 | Osteoarthrosis | Research article

Joint hypermobility is not positively associated with prevalent multiple joint osteoarthritis: a cross-sectional study of older adults

Authors: Terese R. Gullo, Yvonne M. Golightly, Portia Flowers, Joanne M. Jordan, Jordan B. Renner, Todd A. Schwartz, Virginia B. Kraus, Marian T. Hannan, Rebecca J. Cleveland, Amanda E. Nelson

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Login to get access

Abstract

Background

This cross-sectional study evaluated associations of joint hypermobility and multiple joint osteoarthritis (MJOA) in a community-based cohort of adults 45+ years of age.

Methods

MJOA and joint hypermobility data were from 1677 participants (mean age 69 years, 68% women) who completed research clinic visits during 2003–2010. Prevalent MJOA was defined in four ways. Radiographic OA (rOA) was defined as Kellgren-Lawrence (KL) > 2 at any included study joint; symptomatic OA (sxOA) required both symptoms and rOA in a joint. Joint hypermobility was defined as a Beighton score of > 4. Separate logistic regression models were used to estimate odds ratios (OR) between joint hypermobility and each MJOA definition, adjusting for age, sex, race, body mass index, and baseline visit.

Results

In this cohort, 4% had Beighton score > 4 and 63% met any definition of MJOA. Joint hypermobility was associated with significantly lower odds of radiographic and symptomatic MJOA-1 (multiple joint OA-definition 1: involvement of > 1 IP (interphalangeal) nodes and > 2 sites of hip, knee, and spine; 74 and 58% lower, respectively). However, for the other MJOA definitions (i.e., MJOA-2:involvement of > 2 IP joints, > 1 carpometacarpal [CMC] joints, and knee or hip sites; MJOA-3: involvement of > 5 joint sites from among distal interphalangeal, proximal interphalangeal, CMC, hip, knee, or spine sites; and MJOA-4:involvement of > 2 lower body sites (hip, knee, or spine), there were no statistically significant associations. For associations between site-specific hypermobility and any MJOA definition, most adjusted ORs were less than one, but few were statistically significant.

Conclusions

Overall, joint hypermobility was not positively associated with any definition of prevalent MJOA in this cohort, and an inverse association existed with one definition of MJOA. Longitudinal studies are needed to determine the contribution of hypermobility to the incidence and progression of MJOA outcomes.
Literature
1.
Barbour KE, Helmick CG, Boring M, Brady TJ. Vital signs: prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation - United States, 2013-2015. MMWR Morb Mortal Wkly Rep. 2017;66(9):246–53.CrossRefPubMedPubMedCentral
2.
Wolf JM, Cameron KL, Owens BD. Impact of joint laxity and hypermobility on the musculoskeletal system. J Am Acad Orthop Surg. 2011;19(8):463–71.CrossRefPubMed
3.
Kobayasi T. Abnormality of dermal collagen fibrils in Ehlers Danlos syndrome. Anticipation of the abnormality for the inherited hypermobile disorders. Eur J Dermatol. 2004;14(4):221–9.PubMed
4.
Pacey V, Nicholson LL, Adams RD, Munn J, Munns CF. Generalized joint hypermobility and risk of lower limb joint injury during sport: a systematic review with meta-analysis. Am J Sports Med. 2010;38(7):1487–97.CrossRefPubMed
5.
Tobias JH, Deere K, Palmer S, Clark EM, Clinch J. Joint hypermobility is a risk factor for musculoskeletal pain during adolescence: findings of a prospective cohort study. Arthritis Rheum. 2013;65(4):1107–15.CrossRefPubMed
6.
Checa A. Severe cartilage damage of the knee joint in two young women with hypermobility. Rheumatol Int. 2012;32(11):3661–4.CrossRefPubMed
7.
Grahame R. How often, when and how does joint hypermobility lead to osteoarthritis? Br J Rheumatol. 1989;28(4):320.CrossRefPubMed
8.
Sharma L. The role of proprioceptive deficits, ligamentous laxity, and malalignment in development and progression of knee osteoarthritis. J Rheumatol Suppl. 2004;70:87–92.PubMed
9.
Remvig L, Jensen DV, Ward RC. Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature. J Rheumatol. 2007;34(4):804–9.PubMed
10.
Klemp P, Williams SM, Stansfield SA. Articular mobility in Maori and European new Zealanders. Rheumatology (Oxford). 2002;41(5):554–7.CrossRef
11.
Jessee EF, Owen DS Jr, Sagar KB. The benign hypermobile joint syndrome. Arthritis Rheum. 1980;23(9):1053–6.CrossRefPubMed
12.
13.
14.
Scott D, Bird H, Wright V. Joint laxity leading to osteoarthrosis. Rheumatol Rehabil. 1979;18(3):167–9.CrossRefPubMed
15.
Jonsson H, Valtysdottir ST. Hypermobility features in patients with hand osteoarthritis. Osteoarthr Cartil. 1995;3(1):1–5.CrossRef
16.
Godshall RW. The predictability of athletic injuries: an eight-year study. J Sports Med. 1975;3(1):50–4.CrossRefPubMed
17.
Chen HC, Shah SH, Li YJ, Stabler TV, Jordan JM, Kraus VB. Inverse association of general joint hypermobility with hand and knee osteoarthritis and serum cartilage oligomeric matrix protein levels. Arthritis Rheum. 2008;58(12):3854–64.CrossRefPubMedPubMedCentral
18.
Golightly YM, Goode AP, Cleveland RJ, Nelson AE, Hannan MT, Hillstrom HJ, Kraus VB, Schwartz TA, Renner JB, Jordan JM. Relationship of joint hypermobility and lumbar spine pain and osteoarthritis: a cohort study. Ann Rheum Dis. 2016;75(Suppl 2):659.
19.
Goode AP, Cleveland RJ, Schwartz TA, Nelson AE, Kraus VB, Hillstrom HJ, Hannan MT, Flowers P, Renner JB, Jordan JM, et al. Relationship of joint hypermobility with low back pain and lumbar spine osteoarthritis: a pooled analysis of three cross-sectional studies. Osteoarthr Cartil. 2017;25(Suppl 1):S190–1.CrossRef
20.
Golightly YM, Hannan MT, Nelson AE, Hillstrom HJ, Cleveland RJ, Kraus VB, Schwartz TA, Goode AP, Flowers P, Renner JB, et al. Relationship of joint hypermobility with ankle and foot radiographic osteoarthritis and symptoms in a community-based cohort. Arthritis Care Res (Hoboken). 2018; In press.
21.
Flowers PPE, Cleveland RJ, Schwartz TA, Nelson AE, Kraus VB, Hillstrom HJ, Goode AP, Hannan MT, Renner JB, Jordan JM, et al. Association between general joint hypermobility and knee, hip, and lumbar spine osteoarthritis by race: a cross-sectional study. Arthritis Res Ther. 2018;20(1):76.CrossRefPubMedPubMedCentral
22.
Mahler EA, Zweers MC, van Lent PL, Blom AB, van den Hoogen FH, van den Berg WB, Roth J, Vogl T, Bijlsma JW, van den Ende CH, et al. Association between serum levels of the proinflammatory protein S100A8/A9 and clinical and structural characteristics of patients with established knee, hip, and hand osteoarthritis. Scand J Rheumatol. 2015;44(1):56–60.CrossRefPubMed
23.
Visser AW, de Mutsert R, le Cessie S, den Heijer M, Rosendaal FR, Kloppenburg M. The relative contribution of mechanical stress and systemic processes in different types of osteoarthritis: the NEO study. Ann Rheum Dis. 2015;74(10):1842–7.CrossRefPubMed
24.
Sasaki E, Tsuda E, Yamamoto Y, Iwasaki K, Inoue R, Takahashi I, Sawada K, Fujita H, Umeda T, Nakaji S, et al. Serum hyaluronan levels increase with the total number of osteoarthritic joints and are strongly associated with the presence of knee and finger osteoarthritis. Int Orthop. 2013;37(5):925–30.CrossRefPubMedPubMedCentral
25.
Bijsterbosch J, Meulenbelt I, Watt I, Rosendaal FR, Huizinga TW, Kloppenburg M. Clustering of hand osteoarthritis progression and its relationship to progression of osteoarthritis at the knee. Ann Rheum Dis. 2014;73(3):567–72.CrossRefPubMed
26.
Haugen IK, Felson DT, Englund M, Wang K, Aliabadi P, Guermazi A, Roemer FW, Neogi T. The association between erosive hand osteoarthritis and subchondral bone attrition of the knee: the Framingham osteoarthritis study. Ann Rheum Dis. 2012;71(10):1698–701.CrossRefPubMed
27.
Goode AP, Marshall SW, Renner JB, Carey TS, Kraus VB, Irwin DE, Sturmer T, Jordan JM. Lumbar spine radiographic features and demographic, clinical, and radiographic knee, hip, and hand osteoarthritis. Arthritis Care Res (Hoboken). 2012;64(10):1536–44.CrossRef
28.
Cuperus N, Vliet Vlieland TP, Mahler EA, Kersten CC, Hoogeboom TJ, van den Ende CH. The clinical burden of generalized osteoarthritis represented by self-reported health-related quality of life and activity limitations: a cross-sectional study. Rheumatol Int. 2015;35(5):871–7.CrossRefPubMed
29.
Cimmino MA, Scarpa R, Caporali R, Parazzini F, Zaninelli A, Sarzi-Puttini P. Body mass and osteoarthritic pain: results from a study in general practice. Clin Exp Rheumatol. 2013;31(6):843–9.PubMed
30.
Castell MV, van der Pas S, Otero A, Siviero P, Dennison E, Denkinger M, Pedersen N, Sanchez-Martinez M, Queipo R, van Schoor N, et al. Osteoarthritis and frailty in elderly individuals across six European countries: results from the European project on OSteoArthritis (EPOSA). BMC Musculoskelet Disord. 2015;16:359.CrossRefPubMedPubMedCentral
31.
Pereira D, Severo M, Santos RA, Barros H, Branco J, Lucas R, Costa L, Ramos E. Knee and hip radiographic osteoarthritis features: differences on pain, function and quality of life. Clin Rheumatol. 2016;35(6):1555–64.CrossRefPubMed
32.
Wesseling J, Bastick AN, ten Wolde S, Kloppenburg M, Lafeber FP, Bierma-Zeinstra SM, Bijlsma JW. Identifying trajectories of pain severity in early symptomatic knee osteoarthritis: a 5-year Followup of the cohort hip and cohort knee (CHECK) study. J Rheumatol. 2015;42(8):1470–7.CrossRefPubMed
33.
Thomas E, Peat G, Croft P. Defining and mapping the person with osteoarthritis for population studies and public health. Rheumatology (Oxford). 2014;53(2):338–45.CrossRef
34.
Park JH, Hong JY, Han K, Suh SW, Park SY, Yang JH, Han SW. Prevalence of symptomatic hip, knee, and spine osteoarthritis nationwide health survey analysis of an elderly Korean population. Medicine (Baltimore). 2017;96(12):e6372.CrossRef
35.
Veronese N, Trevisan C, De Rui M, Bolzetta F, Maggi S, Zambon S, Musacchio E, Sartori L, Perissinotto E, Crepaldi G, et al. Association of osteoarthritis with Increased Risk of cardiovascular diseases in the elderly: findings from the Progetto Veneto Anziano study cohort. Arthritis Rheumatol. 2016;68(5):1136–44.PubMed
36.
Gullo TR, Golightly YM, Cleveland RJ, Renner JB, Callahan LF, Jordan JM, Kraus VB, Nelson AE. Defining multiple joint osteoarthritis, its frequency and impact in a community-based cohort. Semin Arthritis Rheum. 2018; In press.
37.
Jordan JM, Helmick CG, Renner JB, Luta G, Dragomir AD, Woodard J, Fang F, Schwartz TA, Abbate LM, Callahan LF, et al. Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County osteoarthritis project. J Rheumatol. 2007;34(1):172–80.PubMed
38.
Jordan JM, Linder GF, Renner JB, Fryer JG. The impact of arthritis in rural populations. Arthritis Care Res. 1995;8(4):242–50.CrossRefPubMed
39.
Qin J, Barbour KE, Murphy LB, Nelson AE, Schwartz TA, Helmick CG, Allen KD, Renner JB, Baker NA, Jordan JM. Lifetime risk of symptomatic hand osteoarthritis: the Johnston County osteoarthritis project. Arthritis Rheumatol. 2017;69(6):1204–12.CrossRefPubMedPubMedCentral
40.
Goode AP, Nelson AE, Kraus VB, Renner JB, Jordan JM. Biomarkers reflect differences in osteoarthritis phenotypes of the lumbar spine: the Johnston County osteoarthritis project. Osteoarthr Cartil. 2017;25(10):1672–9.CrossRef
41.
Kraus VB, Li YJ, Martin ER, Jordan JM, Renner JB, Doherty M, Wilson AG, Moskowitz R, Hochberg M, Loeser R, et al. Articular hypermobility is a protective factor for hand osteoarthritis. Arthritis Rheum. 2004;50(7):2178–83.CrossRefPubMed
42.
43.
Gamble JG, Mochizuki C, Rinsky LA. Trapeziometacarpal abnormalities in Ehlers-Danlos syndrome. J Hand Surg Am. 1989;14(1):89–94.CrossRefPubMed
44.
Aydin E, Metin Tellioglu A, Kurt Omurlu I, Turan Y. Impact of generalized joint laxity on plantar loading patterns in young females. Foot Ankle Int. 2017;38(8):909–15.CrossRefPubMed
45.
Foss KD, Ford KR, Myer GD, Hewett TE. Generalized joint laxity associated with increased medial foot loading in female athletes. J Athl Train. 2009;44(4):356–62.CrossRefPubMed
Metadata
Title
Joint hypermobility is not positively associated with prevalent multiple joint osteoarthritis: a cross-sectional study of older adults
Authors
Terese R. Gullo
Yvonne M. Golightly
Portia Flowers
Joanne M. Jordan
Jordan B. Renner
Todd A. Schwartz
Virginia B. Kraus
Marian T. Hannan
Rebecca J. Cleveland
Amanda E. Nelson
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-019-2550-z

Other articles of this Issue 1/2019

BMC Musculoskeletal Disorders 1/2019 Go to the issue

Research article

Tranexamic acid may benefit patients undergoing total hip/knee arthroplasty because of haemophilia

Case report

Aneurysmal bone cyst: results of an off label treatment with Denosumab

Research article

Predicting the evolution of neck pain episodes in routine clinical practice

Research article

The effectiveness of high molecular weight hyaluronic acid for knee osteoarthritis in patients in the working age: a randomised controlled trial

Research article

Comparison of functional metacarpal splint and ulnar gutter splint in the treatment of fifth metacarpal neck fractures: a prospective comparative study

Correspondence

A consensus-based process identifying physical therapy and exercise treatments for patients with degenerative meniscal tears and knee OA: the TeMPO physical therapy interventions and home exercise program