American College of Rheumatology > General Rheumatology

Could Physical Activity Be a Risk Factor for Knee Osteoarthritis?

– Study finds no correlation between recreational activity and incident knee OA – by Sneha Patel, MD July 12, 2022

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In clinical practice, the mainstay of knee osteoarthritis (OA) management is exercise.

As per the 2019 American College of Rheumatology Guidelines, strong recommendations for the management of knee OA also include weight loss, self-management programs, tai chi, and use of a knee brace and cane as supportive therapy.

However, the impact of physical activity in the development risk of primary knee osteoarthritis is unclear.

In a study by Gates et al. in Arthritis & Rheumatology, researchers sought to evaluate the association between recreational physical activity — measured by metabolic equivalents of task (MET) — and time spent in activity and knee OA.

Outcomes measured included pain, pain with OA on knee radiographs and isolated OA on radiographs.

This was a literature review of six observational studies; therefore, direct correlations could not be made and the ability to generalize data may be difficult.

The sample size was over 5,000 patients followed over 5-12 years.

Patients could not have baseline knee OA. Hours spent per week on physical activity (excluding occupational and household), MET days per week, radiographs, and pain via national health and nutrition examination surveys and Western Ontario and McMaster Universities OA index were composed.

Researchers did not find an association between METs or time spent in physical activity with painful radiographic OA, OA-related knee pain, or radiographic OA.

There was also a wide incidence rate for all related outcomes.

This study did not find any correlation between recreational activity (sports, walking, or cycling) with incident knee OA.

Although there were several limitations, such as recall bias with use of surveys and lack of information regarding the type of exercise or intensity, clinicians may be able to use this information in practice.

Providers should continue to help promote exercise, strength training, and weight loss for OA.

We can encourage patients to take part in recreational activity as it likely will not cause OA.

Further studies are needed to identify specific exercises that may in fact reduce the risk of developing knee OA.

Sneha Patel, MD, practices rheumatology in Ft. Worth, Texas.

Read the study here and a Q&A of study highlights here.

Primary Source

Arthritis & Rheumatology

Source Reference: Gates LS, et al « Recreational physical activity and risk of incident knee osteoarthritis: An international meta-analysis of individual participant-level data » Arthritis Rheumatol 2022; 74(4): 612-622.