European Journal of Epidemiology

, Volume 20, Issue 6, pp 537–542 | Cite as

Age, bodyweight, smoking habits and the risk of severe osteoarthritis in the hip and knee in men

  • Bengt JärvholmEmail author
  • Stefan Lewold
  • Henrik Malchau
  • Eva Vingård
Locomotor Diseases


Background:The objective of this study was to estimate the risk of severe osteoarthritis, with the need for arthroplasty, in the knee and/or hip according to body mass index (BMI) both within a normal range and in persons with high BMI. Furthermore, we wanted to study the significance of smoking. Methods: This study identifies male construction workers participating in a national health control program (n = 320,192). The incidence rate for joint replacement was found by matching with the Swedish hospital discharge register between 1987 and 1998. BMI and smoking habit was registered at the time of the health examination. Results: In total 1495 cases of osteoarthritis of the hip and 502 cases of osteoarthritis of the knee were identified and included in this analysis. The incidence rate was found to increase linearly to the BMI even within low and ‚normal BMI. The relative risk for osteoarthritis of the hip was more than two times higher in persons with a BMI of 20–24 than in men with a BMI 17–19. There was almost a doubling of the risk of severe knee osteoarthritis with an increase in BMI of 5 kg/m2. Smoker had a lower risk of osteoarthritis than non-smokers and ex-smokers. Conclusions: BMI is an important predictor of osteoarthritis even within normal BMI. A decreased risk of osteoarthritis of the hip was found in smokers, but the effect was weak compared to that of BMI or age. Contrary to studies of radiographic osteoarthritis our study indicates higher risk of hip than of knee osteoarthritis.


Body mass index (BMI) Construction workers Epidemiology Joint replacement Smoking 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Felson, DT, Lawrence, RC, Dieppe, PA,  et al. 2000Osteoarthritis: New insights. Part 1: The disease and its risk factorsAnn Intern Med133635646PubMedGoogle Scholar
  2. 2.
    Lau, EC, Cooper, C, Lam, D, Chan, VN, Tsang, KK, Sham, A 2000Factors associated with osteoarthritis of the hip and knee in Hong Kong Chinese: Obesity, joint injury, and occupational activitiesAm J Epidemiol152855862PubMedGoogle Scholar
  3. 3.
    Oliveria, SA, Felson, DT, Reed, JI, Cirillo, PA, Walker, AM 1995Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organizationArthritis Rheum3811341141PubMedGoogle Scholar
  4. 4.
    Vingard, E 1991Overweight predisposes to coxarthrosis. Body-mass index studied in 239 males with hip arthroplastyActa Orthop Scand62106109PubMedGoogle Scholar
  5. 5.
    Sturmer, T, Gunther, KP, Brenner, H 2000Obesity, overweight and patterns of osteoarthritis: The Ulm Osteoarthritis StudyJ Clin Epidemiol53307313PubMedGoogle Scholar
  6. 6.
    Flugsrud, GB, Nordsletten, L, Espehaug, B, Havelin, LI, Meyer, HE 2002Risk factors for total hip replacement due to primary osteoarthritis: A cohort study in 50,034 personsArthritis Rheum46675682PubMedGoogle Scholar
  7. 7.
    Gelber, AC, Hochberg, MC, Mead, LA, Wang, NY, Wigley, FM, Klag, MJ 1999Body mass index in young men and the risk of subsequent knee and hip osteoarthritisAm J Med107542548PubMedGoogle Scholar
  8. 8.
    Tepper, S, Hochberg, MC 1993Factors associated with hip osteoarthritis: Data from the First National Health and Nutrition Examination Survey (NHANES-I)Am J Epidemiol13710811088PubMedGoogle Scholar
  9. 9.
    Cooper, C, Inskip, H, Croft, P,  et al. 1998Individual risk factors for hip osteoarthritis: Obesity, hip injury, and physical activityAm J Epidemiol147516522PubMedGoogle Scholar
  10. 10.
    Felson, DT, Anderson, JJ, Naimark, A, Hannan, MT, Kannel, WB, Meenan, RF 1989Does smoking protect against osteoarthritis?Arthritis Rheum32166172PubMedGoogle Scholar
  11. 11.
    Felson, DT, Zhang, Y, Hannan, MT,  et al. 1997Risk factors for incident radiographic knee osteoarthritis in the elderly: The Framingham StudyArthritis Rheum40728733PubMedGoogle Scholar
  12. 12.
    Sandmark, H, Vingard, E 1999Sports and risk for severe osteoarthrosis of the kneeScand J Med Sci Sports9279284PubMedGoogle Scholar
  13. 13.
    Ingvarsson, T 2000Prevalence and inheritance of hip osteoarthritis in IcelandActa Orthop Scand Suppl298146PubMedGoogle Scholar
  14. 14.
    Berry, G 1983The analysis of mortality by the subject-years methodBiometrics39173184PubMedGoogle Scholar
  15. 15.
    Hannan, MT, Felson, DT, Pincus, T 2000Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the kneeJ Rheumatol2715131517PubMedGoogle Scholar
  16. 16.
    Ostendorf, M, Johnell, O, Malchau, H, Dhert, WJA, Schrijvers, AJP, Verbout, AJ 2002The epidemiology of total hip replacement in The Netherlands and Sweden: Present status and future needsActa Orthop73282286Google Scholar
  17. 17.
    Sandmark, H, Hogstedt, C, Lewold, S, Vingard, E 1999Osteoarthrosis of the knee in men and women in association with overweight, smoking, and hormone therapyAnn Rheum Dis58151155PubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Bengt Järvholm
    • 1
    Email author
  • Stefan Lewold
    • 2
  • Henrik Malchau
    • 3
  • Eva Vingård
    • 4
  1. 1.Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
  2. 2.Department of OrthopedicsLund UniversityLund Sweden
  3. 3.Department of OrthopedicsSahlgrenska University HospitalGothenburgSweden
  4. 4.Section of Personal Injury PreventionKarolinska InstituteStockholmSweden

Personalised recommendations