Evidence map›Paper›PMID 32638548›Full record

SynthesisArthritis care & research2020

Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Observational Studies.

Xia Wang, Thomas A Perry, Nigel Arden, Lingxiao Chen, Camille M Parsons, Cyrus Cooper, Lucy Gates, David J Hunter

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Arthritis care & research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Association between Daily Physical Activities and Clinical Knee Osteoarthritis: A Community-Based Study.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Xia WangRoyal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-3172-9390
Thomas A PerryRoyal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia, and University of Oxford, Oxford, UK.ORCID 0000-0002-0499-3033
Nigel ArdenUniversity of Oxford, Oxford, UK, and Southampton General Hospital, University of Southampton, Southampton, UK.
Lingxiao ChenRoyal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0001-7721-0493
Camille M ParsonsSouthampton General Hospital, University of Southampton, Southampton, UK.
Cyrus CooperSouthampton General Hospital, National Institute for Health Research Biomedical Research Centre, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Lucy GatesUniversity of Oxford, Oxford, UK, and University of Southampton, Southampton, UK.
David J HunterRoyal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia.

Funding

Medical Research Council MC_ST_U13058Medical Research Council MC_UU_12011/1
6 · The paper itself

Abstract

objectiveTo assess the association between occupational exposures and knee osteoarthritis (OA).

methodsWe systematically searched for observational studies that examined the relationship between occupational exposures and knee OA and total knee replacement. Four databases were searched up to October 1, 2019. Two reviewers independently assessed study quality using the Newcastle-Ottawa Scale and evidence quality using the Grading of Recommendations Assessment, Development and Evaluation approach. Subgroup meta-analyses were conducted for important study characteristics and each type of occupational exposure. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated for the meta-analysis using random-effects models.

resultsEighty eligible studies were identified including 25 case-control (n = 20,505 total participants), 36 cross-sectional (n = 139,463 total participants), and 19 cohort studies (n = 16,824,492 total participants). A synthesis of 71 studies suggested increased odds of knee OA (OR 1.52 [95% CI 1.37-1.69]) by combining different physically demanding jobs and occupational activities as compared to sedentary occupations and/or low-exposure groups. Odds of knee OA were greater in males and in industry-based studies and studies assessing lifetime occupational exposures. There were 9 specific job titles that were associated with knee OA, including farmer, builder, metal worker, and floor layer. Occupational lifting, kneeling, climbing, squatting, and standing were all associated with higher odds of knee OA as compared to the odds of knee OA in sedentary workers.

conclusionStrenuous, physically demanding occupations and occupational activities were associated with increased odds of knee OA as supported by moderate-quality evidence. Specifically, agricultural and construction sectors, which typically involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing, carried increased odds of knee OA.

Indexed as

HumansIncidenceOccupational DiseasesOsteoarthritis, KneeRiskWeight-Bearing

Identifiers

PMID32638548
PMCPMC7116019

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.