Abstract
OBJECTIVES--To clarify the nature of the relation between hip fractures and osteoarthritis. METHODS--The study was a population based case-control study conducted in Sydney, Australia. Four hundred and sixteen men and women aged 65 years and over were recruited (209 cases, 207 controls). The presence of osteoarthritis was based on self reported pain, swelling, or stiffness of joints in the past year. RESULTS--Among 189 subjects aged 65 to 79 years, but not in older subjects, there was an inverse relation between self reported arthritis in any joint(s) and risk of hip fracture: the age and gender adjusted odds ratio was 0.52 (95% confidence interval 0.27 to 0.98). The prevalence of self reported arthritis of the hip was much lower in patients with hip fracture (4%) than in controls randomly selected from the community (13%); the age and gender adjusted odds ratio was 0.33 (95% confidence interval 0.15 to 0.74). There was also an inverse association between the number of joints reported to be affected by arthritis and risk of hip fracture. These associations were not explained by differences between cases and controls in body mass index or physical activity. CONCLUSIONS--The findings of this study support the hypothesis that there is a causal association between osteoarthritis and osteoporosis of the hip.
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- Cooper C., Cook P. L., Osmond C., Fisher L., Cawley M. I. Osteoarthritis of the hip and osteoporosis of the proximal femur. Ann Rheum Dis. 1991 Aug;50(8):540–542. doi: 10.1136/ard.50.8.540. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Copeland K. T., Checkoway H., McMichael A. J., Holbrook R. H. Bias due to misclassification in the estimation of relative risk. Am J Epidemiol. 1977 May;105(5):488–495. doi: 10.1093/oxfordjournals.aje.a112408. [DOI] [PubMed] [Google Scholar]
- Croft P., Cooper C., Wickham C., Coggon D. Defining osteoarthritis of the hip for epidemiologic studies. Am J Epidemiol. 1990 Sep;132(3):514–522. doi: 10.1093/oxfordjournals.aje.a115687. [DOI] [PubMed] [Google Scholar]
- Cummings S. R., Black D. M., Nevitt M. C., Browner W., Cauley J., Ensrud K., Genant H. K., Palermo L., Scott J., Vogt T. M. Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet. 1993 Jan 9;341(8837):72–75. doi: 10.1016/0140-6736(93)92555-8. [DOI] [PubMed] [Google Scholar]
- Cummings S. R., Black D. M., Rubin S. M. Lifetime risks of hip, Colles', or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med. 1989 Nov;149(11):2445–2448. [PubMed] [Google Scholar]
- Cummings S. R., Kelsey J. L., Nevitt M. C., O'Dowd K. J. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev. 1985;7:178–208. doi: 10.1093/oxfordjournals.epirev.a036281. [DOI] [PubMed] [Google Scholar]
- Felson D. T. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev. 1988;10:1–28. doi: 10.1093/oxfordjournals.epirev.a036019. [DOI] [PubMed] [Google Scholar]
- Foss M. V., Byers P. D. Bone density, osteoarthrosis of the hip, and fracture of the upper end of the femur. Ann Rheum Dis. 1972 Jul;31(4):259–264. doi: 10.1136/ard.31.4.259. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hordon L. D., Wright V., Smith M. A. Bone mass in osteoarthritis. Ann Rheum Dis. 1992 Jun;51(6):823–825. doi: 10.1136/ard.51.6.823. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Knight S. M., Ring E. F., Bhalla A. K. Bone mineral density and osteoarthritis. Ann Rheum Dis. 1992 Sep;51(9):1025–1026. doi: 10.1136/ard.51.9.1025. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nevitt M. C., Cummings S. R., Kidd S., Black D. Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA. 1989 May 12;261(18):2663–2668. [PubMed] [Google Scholar]
- Paganini-Hill A., Chao A., Ross R. K., Henderson B. E. Exercise and other factors in the prevention of hip fracture: the Leisure World study. Epidemiology. 1991 Jan;2(1):16–25. doi: 10.1097/00001648-199101000-00004. [DOI] [PubMed] [Google Scholar]
- Radin E. L. Mechanical aspects of osteoarthrosis. Bull Rheum Dis. 1976;26(7):862–865. [PubMed] [Google Scholar]
- Solomon L., Schnitzler C. M., Browett J. P. Osteoarthritis of the hip: the patient behind the disease. Ann Rheum Dis. 1982 Apr;41(2):118–125. doi: 10.1136/ard.41.2.118. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Weintroub S., Papo J., Ashkenazi M., Tardiman R., Weissman S. L., Salama R. Osteoarthritis of the hip and fracture of the proximal end of the femur. Acta Orthop Scand. 1982 Apr;53(2):261–264. doi: 10.3109/17453678208992213. [DOI] [PubMed] [Google Scholar]