Black Women at Highest TKR Risk

What groups of people—men, women, Whites, Blacks, Hispanics—have the greatest lifetime risk of developing osteoarthritis of the knee? A study by the Orthopaedic and Arthritis Center for Outcomes Research at Brigham and Women’s Hospital in Boston has found that women have a higher risk than do men, and that Black women have the highest risk of all for developing knee OA over their lifetime. Hispanic women came in second. Black and Hispanic women had higher rates of need for a total knee replacement (TKR) than did white women and men of all races.

The lead author of the study Elena Losina, Ph.D., M.Sc., noted that people in their 30s and 40s are developing knee OA more frequently than had been previously believed. She said, “Knee osteoarthritis is not just a disease of the elderly, but is now occurring earlier in life.”

Alice Goodman, writing in Pain Medicine News, reported that the researchers used a computer simulation model to estimate the 10-, 20- and 30-year risk for developing knee OA in six cohorts of black, white and Hispanic men and women aged 40 years. The model assumed that obesity increased the risk for knee OA. Another input factor was the annual incidence of knee TKR among individuals with advanced knee OA from the Multicenter Osteoarthritis Study and Osteoarthritis Initiative data.

The study results, presented at the Annual Meeting of the American College of Rheumatology, showed that Black women had the highest lifetime risk for developing knee OA (17%), whereas White men had the lowest risk (10%). Of the participants who did not have knee OA, 11.3% of Black women, 10.5% of Hispanic women and 10% of White women will develop knee OA by the age of 65 years. The rates of TKR ranged from 6.8% in Black women to 3.8% in Hispanic men.

Goodman quoted Amanda Nelson, M.D., of the University of North Carolina at Chapel Hill’s Thurston Arthritis Research Center, as saying the study is of particular importance given that the elderly population is growing and more people are becoming obese. “The rate of osteoarthritis is increasing, and we are seeing it in younger people, ” she said. “This study emphasizes the importance of lifestyle modifications that may be able to reduce the risk for this common and painful disease, as well as the risk for having to undergo total knee replacement surgery.”