Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
BMC Musculoskelet Disord. 2012 May 17;13:73. doi: 10.1186/1471-2474-13-73.
Studies on leisure time physical activity as risk factor or protective factor for knee or hip osteoarthritis (OA) show divergent results. Longitudinal prospective studies are needed to clarify the association of physical activity with future OA. The aim was to explore in a prospective population-based cohort study the influence of leisure time physical activity on severe knee or hip OA, defined as knee or hip replacement due to OA.
Leisure time physical activity was reported by 28320 participants (mean age 58 years (SD 7.6), 60% women) at baseline. An overall leisure time physical activity score, taking both duration and intensity of physical activities into account, was created. The most commonly reported activities were also used for analysis. The incidence of knee or hip replacement due to OA over 11 years was monitored by linkage with the Swedish hospital discharge register. Cox's proportional hazards model (crude and adjusted for potential confounding factors) was used to assess the incidence of total joint replacement, or osteotomy (knee), in separate analyses of leisure time physical activity.
There was no significant overall association between leisure time physical activity and risk for knee or hip replacement due to OA over the 11-year observation time. For women only, the adjusted RR (95% CI) for hip replacement was 0.66 (0.48, 0.89) (fourth vs. first quartile), indicating a lower risk of hip replacement in those with the highest compared with the lowest physical activity. The most commonly reported activities were walking, bicycling, using stairs, and gardening. Walking was associated with a lower risk of hip replacement (adjusted RR 0.76 (95% CI 0.61, 0.94), specifically for women (adjusted RR 0.75 (95% CI 0.57, 0.98)).
In this population-based study of middle-aged men and women, leisure time physical activity showed no consistent overall relationship with incidence of severe knee or hip OA, defined as joint replacement due to OA, over 11 years. For women, higher leisure time physical activity may have a protective role for the incidence of hip replacement. Walking may have a protective role for hip replacement, specifically for women.
研究休闲时间体力活动作为膝关节或髋关节骨关节炎（OA）的风险因素或保护因素，结果存在差异。需要进行前瞻性纵向研究来阐明体力活动与未来 OA 的关系。本研究旨在通过前瞻性人群队列研究，探讨休闲时间体力活动对严重膝关节或髋关节 OA 的影响，定义为因 OA 进行膝关节或髋关节置换。
28320 名参与者（平均年龄 58 岁（SD 7.6），60%为女性）在基线时报告了休闲时间体力活动。创建了一个综合考虑体力活动持续时间和强度的整体休闲时间体力活动评分。也使用最常见的活动进行分析。通过与瑞典医院出院登记处的链接，监测 11 年内因 OA 导致的膝关节或髋关节置换的发生率。使用 Cox 比例风险模型（未调整和调整潜在混杂因素），分别对休闲时间体力活动与全膝关节置换或膝关节切开术（膝关节）的发生率进行分析。
在 11 年的观察时间内，休闲时间体力活动与因 OA 导致的膝关节或髋关节置换风险之间没有显著的总体关联。仅对于女性，髋关节置换的调整 RR（95%CI）为 0.66（0.48，0.89）（第四四分位与第一四分位相比），表明最高体力活动组的髋关节置换风险较低。最常见的活动是散步、骑自行车、上下楼梯和园艺。散步与髋关节置换风险降低相关（调整 RR 0.76（95%CI 0.61，0.94）），特别是对于女性（调整 RR 0.75（95%CI 0.57，0.98））。
在这项针对中年男女的基于人群的研究中，休闲时间体力活动与 11 年内严重膝关节或髋关节 OA 的发生率（定义为因 OA 进行关节置换）之间没有一致的总体关系。对于女性，较高的休闲时间体力活动可能对髋关节置换的发生率具有保护作用。散步可能对髋关节置换具有保护作用，特别是对于女性。
