Evidence map›Paper›PMID 42252460›Full record

ArticleArthroplasty (London, England)2026

Key determinants for lowering the risk of joint replacement in weight-bearing joints: a population-based cohort study.

Aminu Suleiman, Mojtaba Lotfaliany, Lana J Williams, Amanda L Stuart, Richard Page, Stephen Gill, Anusha P Budehal, Julie A Pasco

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PubMed Full text at PMC Publisher
In one paragraph

Article in Arthroplasty (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Aminu SuleimanDeakin IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, 3220, Australia. a.suleiman@deakin.edu.au.
Mojtaba LotfalianyDeakin IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, 3220, Australia.
Lana J WilliamsDeakin IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, 3220, Australia.
Amanda L StuartDeakin IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, 3220, Australia.
Richard PageDeakin IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, 3220, Australia.
Stephen GillDeakin IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, 3220, Australia.
Anusha P BudehalBarwon Centre for Orthopaedic Research and Education, St John of God Hospital, Geelong, VIC, 3220, Australia.
Julie A PascoDeakin IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, 3220, Australia.

Funding

Deakin University (DUPRS; 628582)NHMRC Emerging Leader Fellowship (ID 1174060)the National Health and Medical Research Council (NHMRC) of Australia (ID 251638, ID 299831, ID 628582)
6 · The paper itself

Abstract

backgroundHip and knee replacement (arthroplasty) is used to treat advanced joint disease by reducing pain and restoring joint function. This study aimed to identify determinants associated with a lower risk of joint replacement (JR).

methodsLongitudinal data from the Geelong Osteoporosis Study (GOS) were used. JR was identified via linkage with the Barwon Joint Registry, medical records, and self-report. Anthropometry, body composition, and blood biomarkers were obtained. Demographics, lifestyle, and comorbidities were self-reported. Fractures were identified from radiological reports. Participants with JR before baseline were excluded, leaving 2,882 eligible participants (1,436 men, 1,446 women; ages 20-96 years). A time-dependent Cox regression model with age as the primary time scale and sex as a stratification variable was fitted. Forward stepwise and the least absolute shrinkage and selection operator (LASSO) regression identified relevant predictors.

resultsOver a median follow-up of 16.7 years (IQR: 9.7-23.2), 223 participants (7.7%) underwent JR. Factors with the reduced risk of JR included lower body mass index (HR 0.96, 95% CI, 0.94-0.99), lower spine bone mineral density (BMD) (0.84, 0.77-0.92), lower procollagen type 1 N-terminal propeptide (0.69, 0.50-0.96), non-fallers (0.74, 0.55-0.99) and no history of cancer (0.66, 0.48-0.90). Lower dietary calcium intake (0.74, 0.52-1.04) was associated with the reduced risk of JR in the main models, but this association was attenuated after accounting for supplement use. Compared with low socioeconomic status (SES), participants with medium and high SES had higher JR risk (1.91, 1.04-3.50; 1.88, 1.13-3.15), although the association was weaker in women (interaction: 0.48, 0.25-0.91).

conclusionAge-related spine degeneration may explain the link between higher spine BMD and JR. The association between lower dietary calcium intake and reduced JR risk is likely driven by confounding by indication or reverse causality. Lower BMI and lower P1NP levels emerged as potentially modifiable pathways. The absence of falls and no history of cancer were associated with reduced JR risk; however, the cancer association was attenuated in the Fine-Gray analysis when competing mortality was accounted for, and the fall association should be interpreted as observational rather than as evidence of a modifiable pathway. Socioeconomic disparities also highlight potential avenues for reducing JR risk. Overall, these findings suggest that biological, lifestyle, and social determinants may play important roles in shaping long-term JR outcomes.

Indexed as

Body compositionComorbiditiesJoint replacementLifestyleOsteoarthritis

Identifiers

PMID42252460
PMCPMC13244897

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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.