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 1/2012

Open Access 01-12-2012 | Research article

Obesity and increased burden of hip and knee joint disease in Australia: Results from a national survey

Authors: Ilana N Ackerman, Richard H Osborne

Published in: BMC Musculoskeletal Disorders | Issue 1/2012

Login to get access

Abstract

Background

Research involving more representative samples is needed to extend our understanding of the broader impact of obesity in hip or knee joint disease (arthritis and OA) beyond clinical settings. Although population-based research has been conducted in the United States, how these findings translate to other countries is unclear. Using a national approach, this study explored associations between obesity and the burden of hip and knee joint disease in Australia (in terms of prevalence, pain, stiffness, function, Health-Related Quality of Life (HRQoL) and disease severity).

Methods

A random sample of 5000 Australians (≥39 years) from the federal electoral roll was invited to complete a mailed questionnaire to identify doctor-diagnosed hip arthritis, hip OA, knee arthritis and knee OA and evaluate the burden of these conditions. Validated questionnaires included the WOMAC Index, Assessment of Quality of Life instrument and Multi-Attribute Prioritisation Tool. Body Mass Index (BMI) was classified into underweight/normal weight (≤24.99 kg/m2), overweight (25–29.99) or obese (≥30). Multiple logistic regression was used to estimate odds of arthritis and OA, with demographic and socioeconomic variables included in the models. Associations between BMI and other variables were investigated using analysis of covariance, with adjustment for age and sex.

Results

Data were available from 1,157 participants (23%). Overweight participants had increased odds of knee arthritis (adjusted OR (AOR) 1.87, 95%CI 1.14-3.07) and knee OA (AOR 2.11, 95%CI 1.07-4.15). Obesity was associated with higher prevalence of hip arthritis (AOR 2.18, 95%CI 1.17-4.06), knee arthritis (AOR 5.47, 95%CI 3.35-8.95) and knee OA (AOR 7.35, 95%CI 3.85-14.02). Of those with arthritis or OA, obese individuals reported more pain (for hip arthritis, hip OA and knee OA), greater stiffness (for hip arthritis, knee arthritis and knee OA), worse function (all diagnoses), lower HRQoL (for hip arthritis and hip OA) and greater disease severity (all diagnoses).

Conclusions

This national study has demonstrated that the odds of arthritis and OA was up to 7 times higher for obese individuals, compared with those classified as underweight/normal weight. Concurrent obesity and joint disease had a marked impact on several key aspects of wellbeing, highlighting the need for public health interventions.
Appendix
Available only for authorised users
Literature
1.
Australian Orthopaedic Association National Joint Replacement Registry: Annual report. 2011, Adelaide: Australian Orthopaedic Association
2.
Sassi F, Devaux M, Cecchini M, Rusticelli E: The obesity epidemic: Analysis of past and projected future trends in selected OECD countries. 2009, Paris: OECD PublishingCrossRef
3.
Australian Institute of Health and Welfare: Australia’s health 2010. 2010, Canberra: Australian Institute of Health and Welfare
4.
Anandacoomarasamy A, Fransen M, March L: Obesity and the musculoskeletal system. Curr Opin Rheumatol. 2009, 21: 71-77. 10.1097/BOR.0b013e32831bc0d7.CrossRefPubMed
5.
Sowers MR, Karvonen-Gutierrez CA: The evolving role of obesity in knee osteoarthritis. Curr Opin Rheumatol. 2010, 22: 533-537. 10.1097/BOR.0b013e32833b4682.CrossRefPubMedPubMedCentral
6.
Lievense A, Bierma-Zeinstra S, Verhagen AP, van Baar ME, Verhaar JAN, Koes BW: Influence of obesity on the development of osteoarthritis of the hip: A systematic review. Rheumatology. 2002, 41: 1155-1162. 10.1093/rheumatology/41.10.1155.CrossRefPubMed
7.
Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF: Obesity and knee osteoarthritis, The Framingham Study. Ann Intern Med. 1988, 109: 18-24.CrossRefPubMed
8.
Hart DJ, Doyle DV, Spector TD: Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women: The Chingford Study. Arthritis Rheum. 1999, 42: 17-24. 10.1002/1529-0131(199901)42:1<17::AID-ANR2>3.0.CO;2-E.CrossRefPubMed
9.
Gelber AC, Hochberg MC, Mead LA, Wang NY, Wigley FM, Klag MJ: Body mass index in young men and the risk of subsequent knee and hip osteoarthritis. Am J Med. 1999, 107: 542-548. 10.1016/S0002-9343(99)00292-2.CrossRefPubMed
10.
Reijman M, Pols HAP, Bergink AP, Hazes JMW, Belo JN, Lievense AM, Bierma-Zeinstra SMA: Body mass index associated with onset and progression of osteoarthritis of the knee but not of the hip: The Rotterdam Study. Ann Rheum Dis. 2007, 66: 158-162.CrossRefPubMed
11.
Grotle M, Hagen K, Natvig B, Dahl F, Kvien T: Obesity and osteoarthritis in knee, hip and/or hand: An epidemiological study in the general population with 10 years follow-up. BMC Musculoskelet Disord. 2008, 9: 132-10.1186/1471-2474-9-132.CrossRefPubMedPubMedCentral
12.
Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, Dragomir A, Kalsbeek WD, Luta G, Jordan JM: Lifetime risk of symptomatic knee osteoarthritis. Arthritis Care Res. 2008, 59: 1207-1213. 10.1002/art.24021.CrossRef
13.
Busija L, Hollingsworth B, Buchbinder R, Osborne RH: Role of age, sex, and obesity in the higher prevalence of arthritis among lower socioeconomic groups: A population-based survey. Arthritis Care Res. 2007, 57: 553-561. 10.1002/art.22686.CrossRef
14.
Busija L, Buchbinder R, Osborne RH: Quantifying the impact of transient joint symptoms, chronic joint symptoms, and arthritis: A population-based approach. Arthritis Rheum. 2009, 61: 1312-1321. 10.1002/art.24508.CrossRefPubMed
15.
16.
Gill T, Hill C, Adams R, Broderick D, Black J, Taylor A: I know I have arthritis but I don’t know what type. Understanding and knowledge of this chronic condition. BMC Musculoskelet Disord. 2010, 11: 174-10.1186/1471-2474-11-174.CrossRefPubMedPubMedCentral
17.
Rosemann T, Grol R, Herman K, Wensing M, Szecsenyi J: Association between obesity, quality of life, physical activity and health service utilization in primary care patients with osteoarthritis. Int J Behav Nutr Phys Act. 2008, 5: 4-10.1186/1479-5868-5-4.CrossRefPubMedPubMedCentral
18.
Losina E, Walensky RP, Reichmann WM, Holt HL, Gerlovin H, Solomon DH, Jordan JM, Hunter DJ, Suter LG, Weinstein AM, et al: Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans. Ann Intern Med. 2011, 154: 217-226.CrossRefPubMedPubMedCentral
19.
Anandacoomarasamy A, Caterson ID, Leibman S, Smith GS, Sambrook PN, Fransen M, March LM: Influence of BMI on Health-related Quality of Life: Comparison between an obese adult cohort and age-matched population norms. Obesity. 2009, 17: 2114-2118. 10.1038/oby.2009.121.CrossRefPubMed
20.
Marks R: Obesity profiles with knee osteoarthritis: Correlation with pain, disability, disease progression. Obesity. 2007, 15: 1867-1874. 10.1038/oby.2007.221.CrossRefPubMed
21.
Perrot S, Poiraudeau S, Kabir-Ahmadi M, Rannou F: Correlates of pain intensity in men and women with hip and knee osteoarthritis. Results of a national survey: The French ARTHRIX study. Clin J Pain. 2009, 25: 767-772. 10.1097/AJP.0b013e3181b43d4f.CrossRefPubMed
22.
Elbaz A, Debbi EM, Segal G, Haim A, Halperin N, Agar G, Mor A, Debi R: Sex and Body Mass Index correlate With Western Ontario and McMaster Universities Osteoarthritis Index and quality of life scores in knee osteoarthritis. Arch Phys Med Rehabil. 2011, 92: 1618-1623. 10.1016/j.apmr.2011.05.009.CrossRefPubMed
23.
Creamer P, Lethbridge-Cejku M, Hochberg MC: Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology. 2000, 39: 490-496. 10.1093/rheumatology/39.5.490.CrossRefPubMed
24.
Ambrose NL, Keogan F, O’Callaghan JP, O’Connell PG: Obesity and disability in the symptomatic Irish knee osteoarthritis population. Ir J Med Sci. 2010, 179: 265-268. 10.1007/s11845-009-0459-5.CrossRefPubMed
25.
Verbrugge LM, Gates DM, Ike RW: Risk factors for disability among U.S. adults with arthritis. J Clin Epidemiol. 1991, 44: 167-182. 10.1016/0895-4356(91)90264-A.CrossRefPubMed
26.
Ettinger WH, Davis MA, Neuhaus JM, Mallon KP: Long-term physical functioning in persons with knee osteoarthritis from NHANES I: Effects of comorbid medical conditions. J Clin Epidemiol. 1994, 47: 809-815. 10.1016/0895-4356(94)90178-3.CrossRefPubMed
27.
Jordan JM, Luta G, Renner JB, Linder GF, Dragomir A, Hochberg MC, Fryer JG: Self-reported functional status in osteoarthritis of the knee in a rural southern community: The role of sociodemographic factors, obesity, and knee pain. Arthritis Care Res. 1996, 9: 273-278. 10.1002/1529-0131(199608)9:4<273::AID-ANR1790090412>3.0.CO;2-F.CrossRefPubMed
28.
Okoro CA, Hootman JM, Strine TW, Balluz LS, Mokdad AH: Disability, arthritis, and body weight among adults 45 years and older. Obes Res. 2004, 12: 854-861. 10.1038/oby.2004.103.CrossRefPubMed
29.
Cheng YJ, Hootman JM, Murphy LB, Langmaid GA, Helmick CG: Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation - United States, 2007–2009. MMWR Morb Mortal Wkly Rep. 2010, 59: 1261-1265.
30.
Allen KD, Helmick CG, Schwartz TA, DeVellis RF, Renner JB, Jordan JM: Racial differences in self-reported pain and function among individuals with radiographic hip and knee osteoarthritis: The Johnston County Osteoarthritis Project. Osteoarthr Cartil. 2009, 17: 1132-1136. 10.1016/j.joca.2009.03.003.CrossRefPubMedPubMedCentral
31.
Allen KD, Chen J-C, Callahan LF, Golightly YM, Helmick CG, Renner JB, Schwartz TA, Jordan JM: Racial differences in knee osteoarthritis pain: Potential contribution of occupational and household tasks. J Rheumatol. 2012, 39: 337-344. 10.3899/jrheum.110040.CrossRefPubMed
32.
Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, et al: Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis Rheum. 2008, 58: 26-35. 10.1002/art.23176.CrossRefPubMedPubMedCentral
33.
Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, Liang MH, Kremers HM, Mayes MD, Merkel PA, et al: Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part I. Arthritis Rheum. 2008, 58: 15-25. 10.1002/art.23177.CrossRefPubMed
34.
Bellamy N: WOMAC Osteoarthritis Index. 2009, Brisbane: Australia: User guide IX
35.
McConnell S, Kolopack P, Davis AM: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): A review of its utility and measurement properties. Arthritis Care Res. 2001, 45: 453-461. 10.1002/1529-0131(200110)45:5<453::AID-ART365>3.0.CO;2-W.CrossRef
36.
Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM: Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res. 2011, 63: S208-S228. 10.1002/acr.20632.CrossRef
37.
Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R, Badley EM: Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med. 2000, 342: 1016-1022. 10.1056/NEJM200004063421405.CrossRefPubMed
38.
Hawthorne G, Richardson J, Osborne R: The Assessment of Quality of Life (AQoL) instrument: A psychometric measure of Health-Related Quality of Life. Qual Life Res. 1999, 8: 209-224. 10.1023/A:1008815005736.CrossRefPubMed
39.
Hawthorne G, Osborne R: Population norms and meaningful differences for the Assessment of Quality of Life (AQoL) measure. Aust N Z J Public Health. 2005, 29: 136-142. 10.1111/j.1467-842X.2005.tb00063.x.CrossRefPubMed
40.
Busija L, Pausenberger E, Haines TP, Haymes S, Buchbinder R, Osborne RH: Adult measures of general health and Health-Related Quality of Life. Arthritis Care Res. 2011, 63: S383-S412. 10.1002/acr.20541.CrossRef
41.
Ackerman IN, Graves SE, Wicks IP, Bennell KL, Osborne RH: Severely compromised quality of life in women and those of lower socioeconomic status waiting for joint replacement surgery. Arthritis Care Res. 2005, 53: 653-658. 10.1002/art.21439.CrossRef
42.
Osborne R, Haynes K, Jones C, Chubb P, Robbins D, Graves S: Orthopaedic Waiting List Project Summary Report. 2006, Melbourne: Victorian Government Department of Human Services
43.
World Health Organization: Obesity: Preventing and managing the global epidemic. 2000, Geneva: World Health Organization
44.
45.
46.
47.
48.
Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C: Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001, 25: 622-627. 10.1038/sj.ijo.0801585.CrossRefPubMed
49.
Grotle M, Hagen K, Natvig B, Dahl F, Kvien T: Prevalence and burden of osteoarthritis: Results from a population survey in Norway. J Rheumatol. 2008, 35: 677-684.PubMed
50.
51.
Creamer P, Lethbridge-Cejku M, Hochberg M: Determinants of pain severity in knee osteoarthritis: Effect of demographic and psychosocial variables using 3 pain measures. J Rheumatol. 1999, 26: 1785-1792.PubMed
52.
Lübbeke A, Duc S, Garavaglia G, Finckh A, Hoffmeyer P: BMI and severity of clinical and radiographic signs of hip osteoarthritis. Obesity. 2009, 17: 1414-1419.PubMed
53.
Sharma L, Cahue S, Song J, Hayes K, Pai Y-C, Dunlop D: Physical functioning over three years in knee osteoarthritis: Role of psychosocial, local mechanical, and neuromuscular factors. Arthritis Rheum. 2003, 48: 3359-3370. 10.1002/art.11420.CrossRefPubMed
54.
Norimatsu T, Osaki M, Tomita M, Ye Z, Abe Y, Honda S, Kanagae M, Mizukami S, Takamura N, Kusano Y, et al: Factors predicting health-related quality of life in knee osteoarthritis among community-dwelling women in Japan: The Hizen-Oshima study. Orthopedics. 2011, 34: e535-e540.PubMed
55.
56.
Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, et al: OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthr Cartil. 2008, 16: 137-162. 10.1016/j.joca.2007.12.013.CrossRefPubMed
57.
Bolen J, Helmick CG, Sacks JJ, Gizlice Z, Potter C: Should people who have joint symptoms, but no diagnosis of arthritis from a doctor, be included in surveillance efforts?. Arthritis Care Res. 2011, 63: 150-154. 10.1002/acr.20313.CrossRef
58.
Dillman DA: Mail and internet surveys. The tailored design method (2nd ed.). 2007, Hoboken: John Wiley & Sons
59.
60.
61.
Flegal KM, Carroll MD, Ogden CL, Johnson CL: Prevalence and trends in obesity among US adults, 1999–2000. JAMA. 2002, 288: 1723-1727. 10.1001/jama.288.14.1723.CrossRefPubMed
Metadata
Title
Obesity and increased burden of hip and knee joint disease in Australia: Results from a national survey
Authors
Ilana N Ackerman
Richard H Osborne
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2012
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-13-254

Other articles of this Issue 1/2012

BMC Musculoskeletal Disorders 1/2012 Go to the issue

Research article

Medication and supplement use for managing joint symptoms among patients with knee and hip osteoarthritis: a cross-sectional study

Technical advance

Reinforcing the role of the conventional C-arm - a novel method for simplified distal interlocking

Research article

The vertical hip fracture – a treatment challenge. A cohort study with an up to 9 year follow-up of 137 consecutive hips treated with sliding hip screw and antirotation screw

Research article

Perceived exertion, comfort and working technique in professional computer users and associations with the incidence of neck and upper extremity symptoms

Research article

The age- and sex-specific occurrence of bothersome neck pain in the general population – results from the Stockholm public health cohort

Research article

Important risk factors and attributable risk of vertebral fractures in the population-based Tromsø study