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Knee Osteoarthritis in Older Adults

Researchers have found that recreational exercise has no effect on the risk of developing knee osteoarthritis (OA). The results of a study, which monitored 1,279 older adults over a 9-year study period, suggested that older adults – even people who are overweight – could participate in recreational exercise without worrying that they might develop knee OA as a result.

David T. Felson, M.D., and his colleagues at Boston University School of Medicine and Brigham and Women’s Hospital studied 1,279 adults (whose parents or in-laws participated in the original Framingham Heart Study). The average age of participants at the start of the study was 53.2 years. After baseline evaluation between 1993 and 1994, the researchers followed the participants for nine years on average, to see if recreational activity levels influenced development of knee OA.

When enrolling the subjects, the researchers asked them about knee pain symptoms and activity levels (including walking or jogging for exercise and working up a sweat). The participants were weighed and x-rays of their knee joints were taken to check for narrowing of joint spaces, which is a sign of OA. Approximately seven years later, participants were quizzed about the extent to which they exercised regularly. And two years following that, subjects were called back in to be weighed and reexamined for OA using knee radiographs and asking questions about knee pain and injury.

Using the data from the baseline and follow-up examinations, the researchers assessed whether exercise had any influence on knee OA. Analysis showed that neither recreational walking, jogging, frequently working up a sweat, nor high activity levels in comparison to peers changed the risks of developing knee OA. Comparing radiographs taken at baseline and at study completion, the authors reported that physical activity did not increase or decrease chances of narrowing of knee joint space, a typical sign of knee OA.

Being overweight or obese is a risk factor for developing OA. Therefore, the researchers looked into the relationship between exercise and knee OA among participants who were overweight or obese. The results were similar to those for all participants: none of the activities that were monitored changed risks of developing knee OA or having narrowed knee joint space. That means that for obese or overweight persons, exercise does not increase the risk of developing knee arthritis, in contrast to results from previous studies.

OA is the most common type of arthritis, and is seen especially among older people. An estimated 12.1 percent of the U.S. population (nearly 21 million Americans) age 25 and older has OA. It is also more likely to occur in people who are overweight and in those with jobs that stress particular joints. OA mostly affects cartilage, the hard slippery tissue that covers the ends of bones where they meet to form a joint. OA most often occurs in the hands, spine, knees and hips. People with OA usually have joint pain and some movement limitations. Fortunately, most people with OA live active, productive lives despite these limitations.