Joint replacements for knee osteoarthritis are becoming more common, and now researchers have identified jobs that may lead to one.

Based on a review of 71 studies that included nearly one million workers, the riskiest occupations include agriculture, construction, mining, service jobs and housekeeping. And jobs that demand excessive kneeling, squatting, standing, lifting and climbing stairs all increase your odds.

A team of researchers from the University of Sydney in Australia, and the Universities of Oxford and Southampton in the United Kingdom found that:

• Carpenters, bricklayers and floor installers have roughly three times the risk for knee osteoarthritis, compared with sedentary workers.
• Farm workers have 64% higher odds for the condition, slightly higher than the 63% for builders and construction workers.
• Housekeeping also carries a risk — with unpaid houseworkers facing up to 93% increased odds for knee osteoarthritis.
• Some jobs were kinder to the knees, however. Workers in commerce, forestry, fishing, machinists, plumbers, electricians, technicians and postal workers did not have a statistically significant risk for knee osteoarthritis, the study found.

“Knee osteoarthritis is a leading cause of loss of work and disability worldwide and can necessitate invasive surgery including total knee replacement, so preventing occupational hazards is critical,” senior study author Dr. David Hunter said in a news release from the University of Sydney, where he leads the Institute of Bone and Joint Research.

Osteoarthritis develops as cartilage deteriorates and bone comes into contact with bone, causing pain and swelling, and limiting function, which affects lifestyle. It can follow an injury, but most of the time the cause is unknown, according to a New York orthopedic surgeon.

“There is a genetic component, but there’s also a lifestyle component,” said Dr. Jeffrey Schildhorn of Lenox Hill Hospital in New York City, who reviewed the findings. One of the biggest risk factors is being overweight or obese.

“I’ve seen arthritis in every walk of life,” he said.

Osteoarthritis is a disease of aging, so it’s not surprising that more people are suffering from it and that the number of joint replacements is soaring, because people are living longer, Schildhorn said. But, he added, there is no miracle cure.

“The thing with arthritis that makes it difficult to deal with is that cartilage has no true regenerative ability,” he said, suggesting that the best way to prevent it is to eat well and watch your weight. Stretching and exercises like yoga will also help keep joints limber, Schildhorn added.

Treatment can include pain medications, and physical or behavioral therapy. But when these don’t work, a knee replacement may be in order.

“Osteoarthritis is mechanical wear and tear,” Schildhorn said. “Some people have more resilient cartilage than others.” If it is very soft and flaky, no treatment is going to work and it has nothing to do with a person’s lifestyle — or their job, he said.

But employers can help by providing physical therapy and teaching workers how to do their jobs with less stress on their knees, Schildhorn said.

The report was recently published in the journal Arthritis Care and Research.

More information

Learn more about knee osteoarthritis from the American Academy of Orthopaedic Surgeons.

SOURCES: Jeffrey Schildhorn, MD, orthopedic surgeon, Lenox Hill Hospital, New York City; University of Sydney, news release, July 8, 2020; Arthritis Care and Research, July 8, 2020