NYC City Health Information, April 2012


Preventing, Diagnosing, and Managing Osteoarthritis or the Hip and Knee
Osteoarthritis is the major cause of chronic musculoskeletal pain and mobility disability in the United States (US) and in New York City (NYC),1-3 where it was the fifth leading cause of healthy years of life lost in 2005.4 Osteoarthritis causes weakness and disability, lowers work productivity, results in joint replacement, and generates an estimated $185 billion per year in the US in medical costs.1,5,6 Osteoarthritis has become more prevalent in recent years. In 2005, an estimated 27 million American adults suffered from symptomatic osteoarthritis of the hips, knees, and hands, up from 21 million in 1995.7 The lifetime risk of developing knee osteoarthritis is 45% overall, but risks are higher in certain groups (see Box 1). People who have had a previous knee injury have a 57% risk of knee osteoarthritis, compared with 42% among those without previous knee injury. Body mass index (BMI) is strongly associated with osteoarthritis of the knee, with risks of 30% for BMI <25, 47% for BMI 25-30, and 60% for BMI > 30. Body weight history also has an effect on risk for knee osteoarthritis: people who maintained a healthy weight from age 18 have the lowest lifetime risk (29%), while those who have a healthy weight at age 18 years and gain weight later in life have the highest risk (60%).8

Osteoarthritis of the hip affects 4% of women and 6% of men aged equal to or less than 55 years in the US, and the risk of developing symptomatic hip osteoarthritis by age 85 is 1 in 4 for both sexes.11 Obesity does not increase lifetime risk for osteoarthritis of the hip, but it is associated with increased risk for total hip replacement.12-13 Because the US population is aging and rates of obesity and overweight are growing, osteoarthritis is likely to affect more and more people in the coming years.1,14,15
Primary care providers (PCPs) should:

  • Recommend that patients control their weight to reduce pressure on weight-bearing joints.10,12,16,17

  • Promote low-impact activity, such as walking, aerobic aquatics, and biking, for all patients, including those with mild to moderate arthritis.11,14,18,19

  • Discuss the potential benefits of physical therapy with patients who have functional limitations.2
  • Continue to DIAGNOSING OSTEOARTHRITIS on the next page >