@article{ref1,
title="Knee symptom but not radiographic knee osteoarthritis increases the risk of falls and fractures: results from the Osteoarthritis Initiative",
journal="Osteoarthritis and cartilage",
year="2021",
author="Cai, Guoqi and Li, Xiaoxi and Zhang, Youyou and Wang, Yining and Ma, Yubo and Xu, Shengqian and Shuai, Zongwen and Peng, Xiaoqing and Pan, Faming",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To describe the effect of knee symptoms and radiographic osteoarthritis (ROA) on the risk of falls, recurrent falls, and fractures. <br><br>DESIGN: Participants from the Osteoarthritis Initiative were classified as having 'no', 'unilateral' or 'bilateral' knee symptoms (≥19 on a 0-96 Western Ontario and McMaster Universities Osteoarthritis Index) and ROA (Kellgren-Lawrence grade ≥2) for each visit. Self-reported falls and fractures in the past 12 months were extracted at baseline and follow-up visits until month 96. Recurrent falls were defined as having ≥2 falls in the past 12 months. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated using mixed-effects complementary log-log regression. <br><br>RESULTS: Of 4465 participants, 3145 (70%), 1681 (38%), and 806 (18%) experienced at least one fall, recurrent fall, and fracture, respectively, over 96 months. Compared to participants without symptomatic knee, unilateral and bilateral knee symptoms were associated with a 17% increased risk of falls and a 36%-46% increased risk of recurrent falls, and bilateral knee symptoms increased the risk of fractures (HR 1.45, 95%CI 1.17 to 1.81). Compared to participants with no ROA in either knee, bilateral ROA was associated with a reduced risk of falls (HR 0.87, 95%CI 0.77 to 0.99) and fractures (HR 0.78, 95%CI 0.64 to 0.96). No statistically significant interactions between knee symptoms and ROA were observed. <br><br>CONCLUSIONS: This large population-based study showed that knee symptoms but not ROA increased the risk of falls, recurrent falls, and fractures, and that adults with bilateral ROA may have a lower risk of falls and fractures.<p /> <p>Language: en</p>",
language="en",
issn="1063-4584",
doi="10.1016/j.joca.2021.11.015",
url="http://dx.doi.org/10.1016/j.joca.2021.11.015"
}