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HomeRheumatologyNo link between physical activity and knee osteoarthritis — Meta-analysis

No link between physical activity and knee osteoarthritis — Meta-analysis

Investigators did not find any link between the amount and duration of physical activity with individuals’ risk of developing knee osteoarthritis, found a long-term meta-analysis in Arthritis & Rheumatology.

The analysis included six global community-based studies including a total of 5,065 participants with and without knee osteoarthritis, who were followed for five to 12 years.

“Knowing that the amount of physical activity and time spent doing it is not associated with the development of knee osteoarthritis is important evidence for both clinicians and the public who may need to consider this when prescribing physical activity for health,” said co-lead author Thomas Perry of the University of Oxford, in the UK.

Next, it will be important to understand the role of injury and specific types of activity within this association, noted co-lead author Lucy Gates of the University of Southampton, and co-senior author Maria Sanchez-Santos of the University of Oxford.

Study details

Recreational Physical Activity and Risk of Incident Knee Osteoarthritis: an international meta‐analysis of individual participant‐level data.

Lucy S. Gates, Thomas A. Perry, Yvonne M. Golightly, Amanda E. Nelson, Leigh F. Callahan, David Felson, Michael Nevitt, Graeme Jones, Cyrus Cooper, Mark E. Batt, Maria T. Sanchez‐Santos, Nigel K. Arden.

Published in Arthritis & Rheumatology on 3 November 2021


The effect of physical activity (PA) on the risk of developing knee osteoarthritis (OA) is unclear. Our aim was to examine the relationship between recreational PA and incident knee OA outcomes using comparable PA and OA definitions.

Data were acquired from six global, community-based cohorts of participants with/without knee OA. Eligible participants had no evidence of knee OA and rheumatoid arthritis (RA) at baseline. Participants were followed for 5-12 years for incident outcomes including: i) radiographic knee OA (ROA) (Kellgren Lawrence (KL) ≥2), ii) painful radiographic knee OA (PROA) (ROA with knee pain) and iii) OA-related knee pain. Self-reported recreational PA included sport and walking/cycling activities was quantified at baseline as metabolic equivalents of tasks (METS) in days per week (days/wk). Risk ratios (RR) were calculated and pooled using Individual Participant Data (IPD) meta-analysis. Secondary analysis assessed the association between PA, defined as time (hrs/wk) spent in recreational PA and incident knee OA outcomes.

Based on a total of N=5065 participants, pooled risk ratio estimates for MET days/wk and PROA (1.02, 95% CI 0.93, 1.12), ROA (1.00, 95% CI 0.94, 1.07) and OA-related knee pain (1.00, 95% CI 0.96, 1.04) were non-significant, respectively. Similarly, analysis of hours per week spent in PA also showed no significant associations for all outcomes.

Our findings suggest that whole-body, physiological energy expenditure during recreational activities and time spent in physical activity were not associated with incident knee OA outcomes.


Arthritis & Rheumatology article – Recreational Physical Activity and Risk of Incident Knee Osteoarthritis: an international meta-analysis of individual participant-level data (Open access)


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