Obesity is related to incidence of patellofemoral osteoarthritis: the Cohort Hip and Cohort Knee (CHECK) study

  • Harvi F. HartEmail author
  • Marienke van Middelkoop
  • Joshua J. Stefanik
  • Kay M. Crossley
  • Sita Bierma-Zeinstra
Cohort Studies


To determine the longitudinal association of baseline body mass index and change in body mass index over 8 years to incident of patellofemoral osteoarthritis at the 8-year follow-up. A sample of 528 women and men, aged 45–65 years, with knee complaints and without radiographic evidence of patellofemoral and tibiofemoral osteoarthritis at baseline, were selected from the Cohort Hip and Cohort Knee cohort. Incidence of patellofemoral osteoarthritis was defined as presence of radiographic patellofemoral osteoarthritis (with or without tibiofemoral osteoarthritis) at the 8-year follow-up. Baseline body mass index data were categorized into normal, overweight, and obese weight-categories. Logistic regression analyses, adjusted for age and sex, were conducted to determine the association of baseline body mass index and change in body mass index to patellofemoral osteoarthritis incidence 8 years later. Obesity was associated with greater odds of radiographic patellofemoral osteoarthritis incident (odds ratio: 1.8 [95% CI 1.1, 3.1]) 8 years later. There were no significant associations observed between body mass index change over 8 years and incidence of radiographic patellofemoral osteoarthritis in overweight and obese individuals. Obesity is associated with increased odds of developing radiographic patellofemoral osteoarthritis 8 years later.


Knee osteoarthritis Body weight Obese Overweight 


Author contributions

All listed authors made substantial contributions to all three sections listed below: (1) The conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, and (3) final approval of the version to be submitted. Study conception: HFH, JJS, KMC. Analysis and interpretation of data: HFH, MvM, JJS, KMC, SB-Z. Manuscript preparation: HFH, MvM, JJS, KMC, SB-Z.


The Cohort Hip and Cohort Knee study is funded by the Dutch Arthritis Foundation. Involved are: Erasmus Medical Center Rotterdam; Kennemer Gasthuis Haarlem; Leiden University Medical Center; Maastricht University Medical Center; Martini Hospital Groningen/Allied Health Care Center for Rheumatology and Rehabilitation Groningen; Medical Spectrum Twente Enschede/Ziekenhuisgroep Twente Almelo; Reade Center for Rehabilitation and Rheumatology; St.Maartens-kliniek Nijmegen; University Medical Center Utrecht; Wilhelmina Hospital Assen. Funding sources had no role in the study design, collection, analysis, and interpretation of the data or the decision to submit the manuscript for publication. All co-authors take full responsibility for the integrity for all aspects of the study and the final manuscript. This material was submitted as an abstract and presented at the 2019 OARSI World Congress on Osteoarthritis.

The Medical Ethics Committee (The Netherlands) Approval Number 02/017-E.

Compliance with ethical standards

Conflict of interest

The author(s) declare that they have no conflict of interest.

Research involving human participants and/or animals

This study used data from human participants.

Informed consent

This study data from the Cohort Hip and Cohort Knee (CHECK) study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Physical Therapy, Faculty of Health Sciences, Collaborative Training Program in Musculoskeletal Health Research, and Bone and Joint InstituteThe University of Western OntarioLondonCanada
  2. 2.La Trobe Sport and Exercise Medicine Research CentreLa Trobe UniversityMelbourneAustralia
  3. 3.Erasmus MCUniversity Medical CenterRotterdamThe Netherlands
  4. 4.Department of Physical Therapy, Movement and Rehabilitation SciencesNortheastern UniversityBostonUSA

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