The title is dramatic. And if you know Pete and I, you know we aren’t overly dramatic guys. But it is becoming increasing more apparent that your knee or hip arthritis isn’t just a problem for your knee and hip joint. So if you have knee or hip arthritis and you are alarmed by the title, good, there is still time to do something about it.

In recent years there have been several studies that link early mortality to knee or hip arthritis.

In 2014 a study in over 4000 people showed severe knee arthritis, both symptoms and x-ray evidence, was associated with increased risk of death.

In 2015 British researchers found middle-aged women with osteoarthritis were more likely to die early. Specifically women with knee pain and x-ray evidence of osteoarthritis had twice the risk of all-cause mortality and more than 3 times the risk of cardiovascular death compared to women without knee pain or evidence of osteoarthritis. There was no link between hand osteoarthritis and increase risk for early death.

In 2015 a Chinese study also found symptomatic knee osteoarthritis was linked to an increased risk of all-cause mortality among over 1000 residents in a rural area in China.

And most recently in February of 2019 in the largest study to date on this topic (which included over 460,000 people) Swedish researchers found the risk of cardiovascular excess deaths increases with the duration of knee and hip osteoarthritis. The most significant cause of death was heart disease and heart failure. Again, arthritis of the hand and other peripheral joints was not linked to an increased risk of death.

It’s early years for uncovering the entire cause and effect here. But we don’t need to wait for researchers to make the obvious link. Arthritis in the weight bearing knees or hips results in loss of function. This loss of function has consequences. Less walking, less stairs, less overall mobility and activity equals less cardiovascular strain. Cardiovascular strain may sound like a problem, but if you want to live long it’s a necessity.

Your medical doctor knows this as well, but our current OHIP health care system doesn’t offer a preventative solution. Our OHIP system offers a referral to a surgeon, and that surgeon will offer you a surgical opinion. As we often tell our patients, you have to be your own health care advocate.

So how can you remain active while battling issues with your hips and knees?

Don’t focus on mobility, prioritize strength and workout intensity (high intensity interval training). Most patients come into our office and are concerned first about the pain and second about the loss of range of movement. While restoring joint movement is important, your heart and blood vessels don’t care if you can bend your knee 125 degrees or 160 degrees. Instead focus on strength training and high intensity training options. We have written previously about the cardiovascular benefit of strength training and high intensity interval training.

So what specific exercises should you do? Well, it depends (and yes we hate that answer too). Because each case of arthritis has its own nuances. But that doesn’t mean everyone needs a customized and supervised program. As a general rule, if an exercise doesn’t cause increased pain during or immediately after an exercise or within 24 hours after, green light. If you have some low intensity, non-disabling pain then yellow light, you may need to collect some more information on that exercise or consult a trusted therapist.

Find a variety of green light exercises that build strength and push your heart rate to its limits at least 4x/week. If you need some guidance, we can help.

For an example of a potential rehab progression plan for knee osteoarthritis check out this video series we did almost 6 years back that have a combined over 50,000 views
https://www.youtube.com/watch?v=77etdS58lhw
https://www.youtube.com/watch?v=QUcvGNFvYvQ
https://www.youtube.com/watch?v=kYT157hIr8s