Total Serum Testosterone and Western Ontario and McMaster Universities Osteoarthritis Index Pain and Function Among Older Men and Women With Severe Knee Osteoarthritis

Abstract

Objective. To investigate whether serum total testosterone level is associated with knee pain and function in men and women with severe knee osteoarthritis (OA). Methods. We enrolled 272 adults age ≥60 years (mean ± SD age 70.4 ± 4.4 years, 53% women) who underwent unilateral total knee replacement (TKR) due to severe knee OA. Serum testosterone levels and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function of the operated and contralateral knee were measured at 6-8 weeks after surgery. At the nonoperated knee, 56% of participants had radiographic knee OA with a Kellgren/Lawrence grade ≥2. Cross-sectional analyses were performed by sex and body mass index (BMI) subgroups, using multivariable regression adjusted for age, physical activity, and BMI. Results. At the operated knee, higher testosterone levels were associated with less WOMAC pain in men (B =-0.62, P = 0.046) and women (B =-3.79, P = 0.02), and less WOMAC disability scores in women (B =-3.62, P = 0.02) and obese men (B =-1.99, P = 0.02). At the nonoperated knee, testosterone levels were not associated with WOMAC pain in men or women, but higher testosterone levels were associated with less disability in women (B =-0.95, P = 0.02). Testosterone levels were inconsistently associated with pain and disability in BMI subgroups among men. Only among obese women, testosterone levels were inversely associated with radiographic knee OA (odds ratio = 0.10, P = 0.003). Conclusion. Higher total testosterone levels were associated with less pain in the operated knee in men and women undergoing TKR and less disability in women. At the nonoperated knee, higher testosterone levels were inconsistently associated with less pain and disability.

Aqueous Extracts of Morus alba Root Bark and Cornus officinalis Fruit Protect against Osteoarthritis Symptoms in Testosterone-Deficient and Osteoarthritis-Induced Rats

“…The incidence of osteoarthritis increases with aging and appears to be associated with age-related declines in sex hormones, including estrogen and testosterone [ 22 ]. After menopause, women are reported to have incremental increases in osteoarthritis risk compared with men of the same age [ 23 ].…”

“…Castrated male rhesus macaques exhibit severe joint osteoarthritis [ 31 ]. Furthermore, higher serum total testosterone concentrations are associated with less pain in elderly men and women with severe knee osteoarthritis [ 22 ]. Higher serum testosterone concentrations are linked to a higher level of LBM, including knee cartilage volume, which delays the damage to articular cartilage.…”

“…Higher serum testosterone concentrations are linked to a higher level of LBM, including knee cartilage volume, which delays the damage to articular cartilage. As life expectancy increases, men are increasingly susceptible to osteoarthritis, although they have higher articular cartilage volume than women [ 22 ].…”

Sex Steroids and Osteoarthritis: A Mendelian Randomization Study

“…age of 70.3 years found that a higher T level was associated with less knee disability in non-operated women and less pain (as determined by the Western Ontario and McMaster Universities Osteoarthritis Index) in normal-weight men (35). In another longitudinal investigation on the association between endogenous sex hormone levels and knee OA features and pain, T level was inversely associated with effusion-synovitis volume and pain score in female OA patients (36).…”

“…In our study, a nominally significant result for the relationship between serum DHT levels and risk of OA in women was found, while little evidence of the sex-specific association between serum T levels and OA was provided. However, a 2-year double-blind cross-sectional analysis of 273 seniors with severe knee OA at an average age of 70.3 years found that a higher T level was associated with less knee disability in non-operated women and less pain (as determined by the Western Ontario and McMaster Universities Osteoarthritis Index) in normal-weight men ( 35 ). In another longitudinal investigation on the association between endogenous sex hormone levels and knee OA features and pain, T level was inversely associated with effusion-synovitis volume and pain score in female OA patients ( 36 ).…”