Genetic factors contribute more to hip than knee surgery due to osteoarthritis – a population-based twin registry study of joint arthroplasty. Issue 6 (June 2017)

• Record Type: Journal Article
• Authors: Magnusson, K.; Scurrah, K.; Ystrom, E.; Ørstavik, R.E.; Nilsen, T.; Steingrímsdóttir, Ó.A.; Ferreira, P.; Fenstad, A.M.; Furnes, O.; Hagen, K.B.
• Is Part Of: Osteoarthritis and cartilage. Volume 25:Issue 6(2017)
• Page Start: 878
• Page End: 884
• Publication Date: 2017-06
• Subjects: Heritability -- Twins -- Osteoarthritis -- Arthroplasty; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Arthrose -- Périodiques; Articulations -- Maladies -- Périodiques; 616.7223005
• DOI: 10.1016/j.joca.2016.12.015
• Languages: English
• ISSNs: 1063-4584

Abstract

Summary: Objective: To explore and quantify the relative strengths of the genetic contribution vs the contribution of modifiable environmental factors to severe osteoarthritis (OA) having progressed to total joint arthroplasty. Design: Incident data from the Norwegian Arthroplasty Registry were linked with the Norwegian Twin Registry on the National ID-number in 2014 in a population-based prospective cohort study of same-sex twins born 1915–60 (53.4% females). Education level and height/weight were self-reported and Body Mass Index (BMI) calculated. The total follow-up time was 27 years for hip arthroplasty (1987–2014, 424, 914 person-years) and 20 years for knee arthroplasty (1994–2014, 306, 207 person-years). We estimated concordances and the genetic contribution to arthroplasty due to OA in separate analyses for the hip and knee joint. Results: The population comprised N = 9058 twin pairs ( N = 3803 monozygotic (MZ), N = 5226 dizygotic (DZ)). In total, 73% (95% confidence intervals (CI) = 66–78%) and 45% (95% CI = 30–58%) of the respective variation in hip and knee arthroplasty could be explained by genetic factors. Zygosity (as a proxy for genetic factors) was associated with hip arthroplasty concordance over time when adjusted for sex, age, education and BMI (HR = 2.98, 95% CI = 1.90–4.67 for MZ compared to DZ twins). Knee arthroplasty was to a greater extent dependent on BMI when adjusted for zygosity and the other covariates (HR = 1.15, 95% CI = 1.02–1.29). Conclusion: Hip arthroplasty was strongly influenced by genetic factors whereas knee arthroplasty to a greater extent depended on a high BMI. The study may imply there is a greater potential for preventing progression of knee OA to arthroplasty in comparison with hip OA.