ArticleArchives of orthopaedic and trauma surgery2025
Association between severe lumbar disc degeneration and end-stage hip or knee osteoarthritis requiring joint replacement surgery: a population-based cohort study with a 26-year follow-up.
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Radiographic assessment of lumbar spine degeneration in patients with total hip arthroplasty: a cross-sectional study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- The relationship between symptom duration in lumbar disc herniation and the prevalence of hip and knee osteoarthritis: A cross-sectional study.Brain & spine · 2026Article
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7 authors.
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Abstract
introductionAn association between intervertebral disc degeneration (IDD) and osteoarthritis (OA) of the hip and knee has been found previously. However, studies using MRI-evaluated IDD grades with large sample sizes are lacking. Total hip and knee arthroplasty (THA and TKA) can be considered an indicator of clinically evident end-stage OA. MATERIALS AND
methodsThe study population consisted of 1,153 postmenopausal Finnish women with clinical back problems, of whom 166 had THA and 295 had TKA during the 26-year follow-up. The study was based on the prospective OSTPRE cohort established in 1989 and Finnish Arthroplasty Register data. The IDD severity was graded from T2-weighted lumbar MRI images using the five-grade Pfirrmann classification. Five intervertebral levels (L1-L2 to L5-S1) were studied (5,765 discs). Cox regression with a time-dependent covariate was used to calculate hazard ratios (HRs) for THA and TKA to account for exposure time for severe degeneration.
resultsA higher hazard for THA was observed in women with severe IDD at the L1-L2 (HR 2.66, 95% CI 1.48-4.80), L2-L3 (HR 1.97, CI 1.15-3.38), L5-S1 (HR 1.69, 95% CI 1.16-2.46) and the L1-S1 (HR 2.19, 95% CI 1.53-3.15) intervertebral levels. Adjustment with potential confounders did not alter the results. Women with severe IDD had an elevated hazard for TKA at the L1-S1 mean degeneration (HR 1.50, CI 1.11-2.02) analysis. However, in the adjusted model, the statistical significance of this association was lost (HR 1.34, 95% CI 0.98-1.84). Higher BMI increased the hazard for both THA and TKA; however, the effect was more substantial for TKA.
conclusionsThe present study supports the association between lumbar IDD and hip OA. A weak association between lumbar IDD and knee OA was observed. Further research is needed to investigate the causality of the relationship between IDD and OA.
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