ArticleOsteoarthritis and cartilage2019
Reproductive factors and risk of total knee replacement due to severe knee osteoarthritis in women, the Singapore Chinese Health Study.
Article in Osteoarthritis and cartilage, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Global, regional and national burden of osteoarthritis in women of childbearing age from 1990 to 2021, with projected trends up to 2045.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Associations between female reproductive factors and osteoarthritis in women ≥ 50 years old: An NHANES 1999-2018 analysis of more than 10,000 women.Immunologic research · 2025Article
- Correlation between Parity and Risk of Osteoarthritis in Elderly Women: A Retrospective Analysis.Journal of orthopaedic case reports · 2025Article
- Association of female reproductive factor with risk of arthritis: a population-based cross-sectional study.Reproductive health · 2025Article
- Article
- Reproductive factors and risk of physical frailty among Chinese women living in Singapore.The journal of nutrition, health & aging · 2024Article
- Article
- Sex Difference in OA: Should We Blame Estrogen?European journal of rheumatology · 2023Article
- Using genetic instruments to estimate the causal effect of hormonal reproductive factors on osteoarthritis.Frontiers in public health · 2022Article
- Food sources of dietary fibre and risk of total knee replacement related to severe osteoarthritis, the Singapore Chinese Health Study.RMD open · 2021Article
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Authors and funding
5 authors at 5 institutions in 2 countries.
Funding
Abstract
objectivesKnee osteoarthritis (OA) is more common in women, and may be related to reproductive or hormonal factors. We evaluated these factors with the risk of total knee replacement (TKR) for severe knee OA among women.
methodsThe Singapore Chinese Health Study recruited 63,257 Chinese aged 45-74 years from 1993 to 1998, and among them, 35,298 were women. Information on height, weight, lifestyle factors, number of biological children, ages at menarche and menopause, and use of hormonal therapies was collected through interviews. Incident cases of TKR were identified via linkage with nationwide database.
resultsThere were 1,645 women with TKR after mean follow-up of 14.8 years. Higher parity was associated with increased TKR risk in a stepwise manner (P for trend <0.001). Compared to nulliparous women, those with ≥5 children had the highest risk [hazard ratio (HR) 2.01, 95% confidence intervals (CIs) 1.50-2.70]. The effect of parity on TKR risk was significantly stronger among lean women compared to heavier women; HRs (95% CIs) for highest parity was 4.86 (2.22-10.63) for women with body mass index (BMI) <23 kg/m
conclusionHigher parity, earlier age of menarche and use of oral contraceptives were associated with increased risk of TKR for severe knee OA among women.
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