The overall goal of the proposed project is to define the contribution of joint hypermobility to lower body osteoarthritis (OA). Results of this study wil inform clinical practice and determine groups at high risk for OA who require targeted prevention or intervention approaches. The rationale for the proposed research is that: 1) joint hypermobility changes joint mechanics, 2) joint hypermobility is an expected independent risk factor for OA, and 3) joint hypermobility increases the risk of injury, a major risk factor for OA. The central hypothesis is that joint hypermobility is associated with lower body OA (lumbar spine, hips, knees, ankles, and feet) and that joint hypermobility magnifies the effects of other OA risk factors (i.e., joint injury).
In Aim 1, we will assess the cross-sectional and longitudinal relationships of joint hypermobility with prevalent, incident, and progressive lumbar spine, hip, and knee OA. We will examine these relationships by age, sex, and body mass index because joint hypermobility declines with age, is more common in women than men, and varies with obesity.
In Aim 2, we will evaluate whether joint hypermobility interacts with joint injury with regard to prevalent, incident, and progressive lumbar spine, hip, and knee OA.
In Aim 3, we will explore the cross- sectional relationship of joint hypermobility and prevalent OA at the foot and ankle, joints that have not been examined in prior studies of joint hypermobility and OA. To achieve these aims, we will conduct the largest study to date of over 6900 participants from three large studies of participants with and without OA. OA, injury, and joint hypermobility data were consistently and identically measured across all 3 studies. The multidisciplinary team includes collaborative and productive researchers and clinicians with expertise in OA and injury epidemiology, rheumatology, musculoskeletal radiology, biomechanics, and biostatistics. The Principal Investigator is an Early Stage Investigator, an OA and injury epidemiologist, and an experienced physical therapist. She is in her final year as a NIH/NCATS (National Center for Advancing Translational Sciences) KL2 Scholar in which she is developing independent research on non-pharmacologic / non- surgical interventions for biomechanical risk factors of OA.

Public Health Relevance

In the United States, the number of people diagnosed with osteoarthritis is rapidly increasing each year, resulting in rising health care costs and more people experiencing disability. Joint hypermobility (commonly referred to as being 'double-jointed') coupled with joint injury may increase the risk for osteoarthritis in the lower body. Sine new prevention and treatment approaches are needed to address the huge public health problem of OA, understanding the role of joint hypermobility in lower body OA can lead to interventions, such as shoes, bracing, or specialized exercises, to promote optimal joint function among people at risk for OA.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Research Project (R01)
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Special Emphasis Panel (ZRG1 (02)M)
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Lester, Gayle E
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University of North Carolina Chapel Hill
Public Health & Prev Medicine
Schools of Public Health
Chapel Hill
United States
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Gullo, Terese R; Golightly, Yvonne M; Cleveland, Rebecca J et al. (2018) Defining multiple joint osteoarthritis, its frequency and impact in a community-based cohort. Semin Arthritis Rheum :
Golightly, Yvonne M; Hannan, Marian T; Nelson, Amanda E et al. (2018) Relationship of Joint Hypermobility with Ankle and Foot Radiographic Osteoarthritis and Symptoms in a Community-Based Cohort. Arthritis Care Res (Hoboken) :
Lateef, Shahmeer; Golightly, Yvonne M; Renner, Jordan B et al. (2017) A Cross-sectional Analysis of Radiographic Ankle Osteoarthritis Frequency and Associated Factors: The Johnston County Osteoarthritis Project. J Rheumatol 44:499-504
Nelson, Amanda E; Golightly, Yvonne M; Lateef, Shahmeer et al. (2017) Cross-sectional associations between variations in ankle shape by statistical shape modeling, injury history, and race: the Johnston County Osteoarthritis Project. J Foot Ankle Res 10:34