Background/Purpose: Previous studies of the relationships between female reproductive factors and osteoarthritis (OA) have shown conflicting results. In this study, we aimed to explore the relationships between reproductive factors and joint replacement arthroplasty of the knee (TKRA) and hip (THRA) in a large nationwide population-based cohort of postmenopausal Korean women.

Methods: We included 1,218,257 subjects who participated in national health examinations in 2009 in the study. The study outcomes were incident THRA or TKRA due to severe hip or knee OA. The relationships between reproductive factors and THRA or TKRA were evaluated using a multivariate-adjusted proportional hazards model.

Results: During a mean follow-up duration of 8.2 years, 1,733 incident THRA cases and 65,108 incident TKRA cases were observed. Later age at menarche, longer breastfeeding, HRT and OC use were associated with increased risk of TKRA for severe knee OA, while later age at menopause and longer reproductive span were associated with decreased risk. With regard to THRA for severe hip OA, later menarche, longer breastfeeding, and HRT more than 5 years were associated with higher risk. The associations between reproductive factors and severe OA were more pronounced in underweight and younger subjects.

Conclusion: We found that shorter estrogen exposure was associated with higher risk of joint replacement therapy due to severe OA, and such associations were more pronounced in underweight and younger subjects.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/female-reproductive-factors-and-risk-of-joint-replacement-arthroplasty-of-the-knee-and-hip-due-to-osteoarthritis-in-postmenopausal-women-a-nationwide-cohort-study-of-1-36-million-women/