Osteoarthritis and the Incidence of Fracture in the UK

Sarfaroj Khan 


January 19, 2021


  • Osteoarthritis (OA) was positively associated with the incidence of fractures.

  • This association between OA and fracture was significant in all sex, age and OA joint site subgroups.

Why this matters

  • Findings highlight the urgent need for intervention to reduce the risk of fracture in adults with OA.

  • Future studies are warranted to gain a better insight into the mediators involved in the association between OA and fracture.

Study design

  • A retrospective cohort study of 129,348 patients who had received an initial diagnosis of OA (aged, ≥18 years) in one of 256 general practices in the UK between 1997 and 2016 (index date).

  • Patients with OA were matched (1:1) to those without OA by sex, age, index year, diabetes, dementia, corticosteroid therapy and practice.

  • All patients were followed from the index date for up to 10 years for incidence of any fracture.

  • Funding: None.

Key results

  • After 10 years of follow-up, 12.1% of participants with OA and 7.7% of those without OA had suffered ≥1 fracture (log-rank P<.001).

  • A positive and significant association was seen between OA and fracture (HR, 1.55; 95% CI, 1.50-1.60; P<.001). 

  • The association between OA and fracture was significant in all sex, age and OA joint site subgroups (HR; 95% CI):

    • men (1.58; 1.48-1.69);

    • women (1.55; 1.49-1.61);

    • age 18-50 years (1.62; 1.48-1.78);

    • age 51-60 years (1.40; 1.30-1.51);

    • age 61-70 years (1.42; 1.32-1.53);

    • age 71-80 years (1.56; 1.45-1.67);

    • age >80 years (1.61; 1.47-1.75);

    • polyarthritis group (1.60; 1.41-1.81);

    • hip OA group (1.40; 1.23-1.60);

    • knee OA group (1.36; 1.16-1.59); and

    • other and unspecified OA group (1.57; 1.51-1.63).


  • Retrospective design.


Jacob L, Kostev K. Osteoarthritis and the incidence of fracture in the United Kingdom: a retrospective cohort study of 258,696 patients. Osteoarthritis Cartilage. 2020 Dec 21 [Epub ahead of print]. doi: 10.1016/j.joca.2020.12.006. PMID: 33359250.  View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: