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The impact of body mass index on later total hip arthroplasty for primary osteoarthritis: a cohort study in 1.2 million persons.

Flugsrud GB, Nordsletten L, Espehaug B, Havelin LI, Engeland A, Meyer HE

Oslo Orthopaedic Centre, Ullevål University Hospital, Oslo, Norway. Gunnar.Flugsrud@ioks.uio.no

OBJECTIVE: To investigate the effects of body mass index (BMI), height, and age on the risk of later total hip arthroplasty for primary osteoarthritis (OA). METHODS: We matched screening data on body height and weight from 1,152,006 persons ages 18-67 years who attended a compulsory screening for tuberculosis in 1963-1975 with data from the Norwegian Arthroplasty Register for the years 1987-2003. We identified 28,425 total hip replacements because of primary OA. RESULTS: We found dose-response associations between both height and BMI and later hip arthroplasty. The relative risk (RR) among men with a BMI > or = 32 kg/m2 versus a BMI of 20.5-21.9 kg/m2 was 3.4 (95% confidence interval [95% CI] 2.9-4.0). The corresponding RR in women was 2.3 (95% CI 2.1-2.4). There was a decreasing trend in the RR with an increasing age at screening. Among men, the RR for an increase of 5 kg/m2 in the BMI was 2.1 (95% CI 1.7-2.5) when measured at age <25 years and 1.5 (95% CI 1.3-1.7) when measured at ages 55-59 years. Among women, the corresponding RR values were 1.7 (95% CI 1.5-1.9) and 1.1 (95% CI 1.1-1.2). CONCLUSION: There was a strong dose-response association between BMI and later total arthroplasty for OA of the hip. Being overweight entailed the highest RR among young participants, and the participants who were overweight at a young age maintained an excess RR for arthroplasty throughout the followup period.

Published 7 March 2006 in Arthritis Rheum, 54(3): 802-7.
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