Aging
Identification of Risk Factors for Glenohumeral Osteoarthritis Requiring Shoulder Arthroplasty Elizabeth L. Yanik* Elizabeth Yanik Abigail G. Carey-Ewend Xiaoyi Xu Jay D. Keener Vy Pham
Glenohumeral osteoarthritis (OA) is a leading cause of disabling shoulder pain. Shoulder arthroplasty (SA) rates for OA in the US are increasing more rapidly than for hip or knee arthroplasty (THA/TKA). But understanding of the factors influencing glenohumeral OA risk is limited. We aimed to identify factors associated with OA-related SA, as a measure of end-stage glenohumeral OA, in the UK Biobank. The UK Biobank collects extensive data from surveys, interviews, and linked hospital records covering 10+ follow-up years. An OA SA case was defined as presence of a SA procedure code with an OA diagnosis before or at the time of the procedure. Age-adjusted Cox regression was used to estimate associations between each potential risk factor and OA SA. All factors with evidence of association based on age-adjusted models (P>0.10) were included in a final multivariable Cox model to evaluate independent associations. Factors included in the final model were also evaluated with OA-related THA/TKA using similar methods to compare the magnitude of associations across joints. Of the 494,203 people included, 652 underwent OA SA during follow-up. In the final multivariable model, each decade increase in age was associated with twice the OA-related SA risk. Higher BMI was strongly associated with higher risk, with obese individuals having over three times the risk of people with healthy BMI. BMI associations were weaker for THA and stronger for TKA (Fig.) OA SA risk increased consistently with increasing frequency of manual work, while vigorous physical activity was only associated with elevated risk at the very highest levels. The highest levels of manual work and physical activity were more strongly associated with OA SA than THA or TKA (Fig.). Similar factors may drive OA in the shoulder, a non-weight-bearing joint, as do weight-bearing joints, but the magnitude of associations differed by joint. Continued investigation of glenohumeral OA risk factors is critically needed to inform prevention approaches.
