Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, 230032, Anhui, China.
Arthritis Res Ther. 2023 Sep 29;25(1):184. doi: 10.1186/s13075-023-03179-4.
Studies evaluating the association of knee and hip osteoarthritis (OA) with falls and fractures have inconsistent findings. We aimed to investigate associations of symptomatic and radiographic knee and hip OA with risk of falls, recurrent falls, and fractures.
We conducted an electronic search of databases from inception to February 2023. Two authors independently screened studies, extracted data, and assessed the risk of bias using the Newcastle-Ottawa Scale tool in eligible studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models.
Of 17 studies included (n = 862849), 2 had a high risk of bias. Among studies that evaluated falls or fractures as outcomes, 7/8 (87.5%) and 5/11 (45.5%) were self-reported, respectively. Both symptomatic knee and hip OA were associated with increased risk of recurrent falls (knee: OR = 1.55, 95% CI 1.10 to 2.18; hip: OR = 1.50, 95% CI 1.28 to 1.75) but not falls or fractures. Radiographic knee OA increased risk of falls (OR = 1.28, 95% CI 1.03 to 1.59) and did not significantly increase risk of recurrent falls (OR = 1.39, 95% CI 0.97 to 1.97) or fractures (OR = 1.22, 95% CI 0.99 to 1.52). Radiographic hip OA decreased the risk of recurrent falls (OR = 0.70, 95% CI 0.51 to 0.96) but had no statistically significant association with fractures (OR = 1.16, 95% CI 0.79 to 1.71).
Symptomatic knee and hip OA were both associated with an increased risk of recurrent falls, and radiographic knee OA was associated with an increased risk of falls. No statistically significant associations of radiographic and symptomatic knee or hip OA with fractures were found.
评估膝关节和髋关节骨关节炎（OA）与跌倒和骨折之间关联的研究结果不一致。我们旨在研究有症状和放射学膝关节和髋关节 OA 与跌倒、复发性跌倒和骨折风险的相关性。
我们对从成立到 2023 年 2 月的数据库进行了电子检索。两位作者独立筛选研究，使用纽卡斯尔-渥太华量表工具评估合格研究中的偏倚风险，并提取数据。使用随机效应模型计算合并的比值比（OR）及其 95%置信区间（CI）。
纳入的 17 项研究（n=862849）中，有 2 项研究存在高偏倚风险。在评估跌倒或骨折作为结局的研究中，87.5%（7/8）和 45.5%（5/11）分别为自我报告。有症状的膝关节和髋关节 OA 均与复发性跌倒风险增加相关（膝关节：OR=1.55，95%CI 1.10 至 2.18；髋关节：OR=1.50，95%CI 1.28 至 1.75），但与跌倒或骨折无关。放射学膝关节 OA 增加了跌倒风险（OR=1.28，95%CI 1.03 至 1.59），但并未显著增加复发性跌倒（OR=1.39，95%CI 0.97 至 1.97）或骨折（OR=1.22，95%CI 0.99 至 1.52）的风险。放射学髋关节 OA 降低了复发性跌倒的风险（OR=0.70，95%CI 0.51 至 0.96），但与骨折无统计学显著相关性（OR=1.16，95%CI 0.79 至 1.71）。
有症状的膝关节和髋关节 OA 均与复发性跌倒风险增加相关，放射学膝关节 OA 与跌倒风险增加相关。放射学和有症状的膝关节或髋关节 OA 与骨折之间无统计学显著相关性。
