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Knee Osteoarthritis and Adverse Health Outcomes: An Umbrella Review of Meta-Analyses of Observational Studies

journal contribution
posted on 2023-08-30, 20:18 authored by Nicola Veronese, Germain Honvo, Olivier Bruyere, Rene Rizzoli, Mario Barbagallo, Stefania Maggi, Lee Smith, Shaun Sabico, Nasser Al-Daghri, Cyrus Cooper, Francesco Pegreffi, Jean-Yves Reginster
Background Knee osteoarthritis (OA) is a common condition, associated with a high rate of disability and poor quality of life. Despite the importance of such evidence in public health, no umbrella review (i.e., a review of other systematic reviews and meta-analyses) has systematically assessed evidence on association between knee OA and adverse health outcomes. Aims To map and grade all health outcomes associated with knee OA using an umbrella review approach. Methods The search was made across several databases up to 22 April 2022. We used an umbrella review of systematic reviews with meta-analyses of observational studies assessing the effect sizes, based on random effect summary, 95% prediction intervals, heterogeneity, small study effects, and excess significance bias. The evidence was then graded from convincing (class I) to weak (class IV). Results Among 3,847 studies initially considered, five meta-analyses were included for a total of five different outcomes. Three adverse outcomes were significantly associated with knee OA (i.e., cardiovascular mortality, falls, and subclinical atherosclerosis). The presence of knee OA was associated with a significantly higher risk of cardiovascular mortality (odds ratio, OR = 1.17; 95%CI, confidence intervals: 1.02–1.34), falls (RR = 1.34; 95%CI: 1.10–1.64), and conditions associated with subclinical atherosclerosis (OR = 1.43; 95%CI: 1.003–2.05). The certainty of each of this evidence was weak. Conclusions Our umbrella review suggests that knee OA can be considered as putative risk factor for some medical conditions, including cardiovascular diseases and falls, however, it is important to note that the evidence is affected by potential biases.

History

Refereed

  • Yes

Publication title

Aging Clinical and Experimental Research

ISSN

1720-8319

Publisher

Springer

File version

  • Accepted version

Language

  • eng

Legacy posted date

2022-11-14

Legacy creation date

2022-11-14

Legacy Faculty/School/Department

Faculty of Health, Education, Medicine & Social Care

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