Evidence map›Paper›PMID 32938637›Full record

ArticleAnnals of the rheumatic diseases2020

Risk of venous thromboembolism in knee, hip and hand osteoarthritis: a general population-based cohort study.

Chao Zeng, Kim Bennell, Zidan Yang, Uyen-Sa D T Nguyen, Na Lu, Jie Wei, Guanghua Lei, Yuqing Zhang

Open access · hybridAbstract read
In one paragraph

Article in Annals of the rheumatic diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 6% of its field
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

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.

  1. Pooled it
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  8. Management of Venous Thromboembolism After Hip and Knee Arthroplasty.Journal of orthopaedics and sports medicine · 2025
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  15. Anterior cruciate ligament tear increases the risk of venous thromboembolism: a population-based cohort study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 4 countries.

Chao ZengDepartment of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Kim BennellCentre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Zidan YangHunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China.
Uyen-Sa D T NguyenDepartment of Biostatistics and Epidemiology, University of North Texas Health Science Center, School of Public Health, Fort Worth, Texas, USA.
Na LuArthritis Research Centre, Richmond, British Columbia, Canada.
Jie WeiDivision of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Guanghua LeiDepartment of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China lei_guanghua@csu.edu.cn yzhang108@mgh.harvard.edu.ORCID 0000-0003-2987-138X
Yuqing ZhangDivision of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA lei_guanghua@csu.edu.cn yzhang108@mgh.harvard.edu.ORCID 0000-0001-7638-0888
Harvard University · USCentral South University · CNArthritis Research Centre of Canada · CAThe University of Melbourne · AUUniversity of North Texas · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOsteoarthritis is a leading cause of immobility and joint replacement, two strong risk factors for venous thromboembolism (VTE). We aimed to examine the relation of knee, hip and hand osteoarthritis to the risk of VTE and investigate joint replacement as a potential mediator.

methodsWe conducted three cohort studies using data from The Health Improvement Network. Up to five individuals without osteoarthritis were matched to each case of incident knee (n=20 696), hip (n=10 411) or hand (n=6329) osteoarthritis by age, sex, entry time and body mass index. We examined the relation of osteoarthritis to VTE (pulmonary embolism and deep vein thrombosis) using a multivariable Cox proportional hazard model.

resultsVTE developed in 327 individuals with knee osteoarthritis and 951 individuals without osteoarthritis (2.7 vs 2.0 per 1000 person-years), with multivariable-adjusted HR being 1.38 (95% CI 1.23 to 1.56). The indirect effect (HR) of knee osteoarthritis on VTE through knee replacement was 1.07 (95% CI 1.01 to 1.15), explaining 24.8% of its total effect on VTE. Risk of VTE was higher in hip osteoarthritis than non-osteoarthritis (3.3 vs 1.8 per 1000 person-years; multivariable-adjusted HR=1.83, 95% CI 1.56 to 2.13). The indirect effect through hip replacement yielded an HR of 1.14 (95% CI 1.04 to 1.25), explaining 28.1% of the total effect. No statistically significant difference in VTE risk was observed between hand osteoarthritis and non-osteoarthritis (1.5 vs 1.6 per 1000 person-years; multivariable-adjusted HR=0.88, 95% CI 0.67 to 1.16).

conclusionOur large population-based cohort study provides the first evidence that knee or hip osteoarthritis, but not hand osteoarthritis, was associated with an increased risk of VTE, and such an association was partially mediated through knee or hip replacement.

Indexed as

AgedArthroplasty, ReplacementCohort StudiesFemaleHumansIncidenceMaleMiddle AgedOsteoarthritisRisk FactorsVenous Thromboembolismepidemiologykneeosteoarthritis

Identifiers

PMID32938637
PMCPMC7677492
OpenAlexW3085311162

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.