Association Between Knee Osteoarthritis and Injurious Falls in Older Adults

Closeup over the shoulder view of an early 60’s senior gentleman having some knee pain. He’s at doctor’s office having medical examination by a male doctor. The doctor is touching the sensitive area and trying to determine the cause of pain.
Researchers found an association between symptomatic radiographic knee osteoarthritis and risk for medically treated injurious falls in older men.

For the first time, the association between symptomatic radiographic knee osteoarthritis and the overall and gender-based risk for medically treated injurious falls among older adults has been studied. The researchers published their results in the Arthritis Care & Research.1

Older adults (≥65 years) are commonly faced with the challenge of knee osteoarthritis and one-third of such men and women reported pain according to results from previous research.2 However, less is known about risk for injurious falls among adults with knee osteoarthritis, which has significant clinical relevance. The current study included white and African American participants with a mean age of 74.7 ± 2.9 years using data from the Health Aging and Body Composition Knee Osteoarthritis Substudy. The researchers used the Cox regression model to calculate hazard ratios and 95% CIs. The mean follow-up was 6.59 years.

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Results showed that of 734 participants, 34.7% experienced injurious falls during the study period. Of 288 men, 77 reported injurious falls because of knee osteoarthritis/pain, and among 446 women, there were 178 injurious falls that were not dependent on their condition of knee osteoarthritis. In the multivariate analyses, the investigators indicated that among men only, those with symptomatic radiographic osteoarthritis had a significantly increased risk for knee osteoarthritis-related injurious falls compared with men who did not have radiographic osteoarthritis or pain (hazard ratio, 2.57; 95% CI, 1.12-5.91). However, no such association existed for women.

While the study design had some benefits, the researchers noted some limitations that could have been responsible for reduced associations: measurements for knee osteoarthritis were made only at baseline, patients were in differing physical states, and few older adults with radiographic knee osteoarthritis but no pain were included.

“In summary, in a cohort of older men and women, knee [symptomatic radiographic osteoarthritis] was independently associated with a 2.6-fold increased risk of incident injurious falls in men only,” concluded the investigators. “More studies are needed to confirm this initial finding and explore why this association was limited to men.”


  1. Barbour KE, Sagawa N, Boudreau RM, et al. Knee osteoarthritis and the risk of medically treated injurious falls among older adults: a community-based US cohort study. Arthritis Care Res. 2019;71(7):865-874.
  2. Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol. 2006;33(11):2271-2279.