TKR, KOA and gout
According to several cross-sectional and retrospective case-control studies, gout seems to be associated with knee osteoarthritis (KOA), say rheumatologists from Singapore. However, to date there has been no prospective study to analyze the risk of total knee replacement (TKR) for KOA in association with gout. The aim of the present study was therefore to prospectively evaluate the association between gout and the risk of TKR due to severe KOA. The results confirmed the association between gout and risk of severe KOA, in particular in lean women.
The authors analyzed data from the Singapore Chinese Health Study (SCHS), a prospective cohort including 51,858 Chinese adults aged 45-74 years, who were asked to report physician-diagnosed gout.
After an average follow-up of 9.7 years, 1,435 cases of TKR were noted. Gout was associated with a 39 % higher risk of TKR in women (hazard ratio [HR] 1.39) but not in men (HR 0.78). This association was stronger in lean women (body mass index < 23 kg/m2) than in heavier women (HR 2.17).
Gout is associated with risk of severe KOA, especially in lean women. According to the authors, this may indicate the potential role of crystal arthritis in the pathogenesis and/or progression of OA.