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. 2017 Jun;69(6):1204-1212.
doi: 10.1002/art.40097. Epub 2017 May 8.

Lifetime Risk of Symptomatic Hand Osteoarthritis: The Johnston County Osteoarthritis Project

Jin Qin  1 , Kamil E Barbour  1 , Louise B Murphy  1 , Amanda E Nelson  2 , Todd A Schwartz  2 , Charles G Helmick  1 , Kelli D Allen  2 , Jordan B Renner  2 , Nancy A Baker  3 , Joanne M Jordan  2
Affiliations

Lifetime Risk of Symptomatic Hand Osteoarthritis: The Johnston County Osteoarthritis Project

Jin Qin et al. Arthritis Rheumatol. 2017 Jun.

Abstract

Objective: Symptomatic hand osteoarthritis (OA) is a common condition that affects hand strength and function, and causes disability in activities of daily living. Prior studies have estimated that the lifetime risk of symptomatic knee OA is 45% and that of hip OA is 25%. The objective of the present study was to estimate the overall lifetime risk of symptomatic hand OA, and the stratified lifetime risk according to potential risk factors.

Methods: Data were obtained from 2,218 adult subjects (ages ≥45 years) in the Johnston County Osteoarthritis Project, a population-based prospective cohort study among residents of Johnston County, North Carolina. Data for the present study were collected from 2 of the follow-up cycles (1999-2004 and 2005-2010). Symptomatic hand OA was defined as the presence of both self-reported symptoms and radiographic OA in the same hand. Lifetime risk, defined as the proportion of the population who will develop symptomatic hand OA in at least 1 hand by age 85 years, was estimated from models using generalized estimating equations.

Results: Overall, the lifetime risk of symptomatic hand OA was 39.8% (95% confidence interval [95% CI] 34.4-45.3%). In this population, nearly 1 in 2 women (47.2%, 95% CI 40.6-53.9%) had an estimated lifetime risk of developing symptomatic hand OA by age 85 years, compared with 1 in 4 men (24.6%, 95% CI 19.5-30.5%). Race-specific symptomatic hand OA risk estimates were 41.4% (95% CI 35.5-47.6%) among whites and 29.2% (95% CI 20.5-39.7%) among African Americans. The lifetime risk of symptomatic hand OA among individuals with obesity (47.1%, 95% CI 37.8-56.7%) was 11 percentage points higher than that in individuals without obesity (36.1%, 95% CI 29.7-42.9%).

Conclusion: These findings demonstrate the substantial burden of symptomatic hand OA overall and in sociodemographic and clinical subgroups. Increased use of public health and clinical interventions is needed to address its impact.

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Figures

Appendix Figure
Appendix Figure
Cumulative risk curves by age for A. Persons with less than high school, completed high school, and with higher than high school education; B. Persons having less and more frequent occupational hand-held tool use in the longest job; C. Persons with and without prior hand injury. The shaded bands represent the 95% confidence intervals for the estimated cumulative risk.
Figure 1
Figure 1
Flowchart for symptomatic hand OA analytic sample: Johnston County Osteoarthritis Project aIneligible at Time 2 (n=730) because of the following reasons:

  1. Physical/mental unable to participate (n=165)

  2. Moved away (n=160)

  3. Deceased (n=358)

  4. Unknown (n=47)

Figure 2
Figure 2
Cumulative risk curves by age for A. Men and women; B. White and Black; C. Obese and non-obese Individuals. The shaded bands represent the 95% confidence intervals for the estimated cumulative risk.
See this image and copyright information in PMC

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