Osteoarthritis across Joint Sites in the Million Veteran Program: Insights from Electronic Health Records and Military Service History

ObjectiveTo characterize the relationship between OA frequency and a host of demographic characteristics, comorbidities, military service history, and physical health variables in a veteran population. MethodsWe investigated the Million Veteran Program (MVP) cohort to outline frequency of OA across six joint sites (knee, spine, hip, hand, finger, thumb) in veterans with respect to demographics (age, sex, race/ethnicity, etc.), military service data, and detailed electronic health records profiling OA and other comorbidities. The large veteran contingent provided the unique opportunity to investigate the association of OA with prior service across military branches and war eras. ResultsWe validated previous reports of sex- and age-dependent differences in OA frequency, and we identified that generalized OA was associated with a higher frequency of sixteen Deyo-Charlson comorbidities. These associations generally persisted within each isolated joint site-specific OA. Depending on military branch, prior military engagement was differentially associated with frequency of OA. Prior Army and Navy service were associated with higher and lower risk, respectively of OA across all joint sites. However, multivariable-adjusted models adjusting for a range of covariates (including age, sex, and ancestry) reversed the apparent protective effect of prior Navy service ConclusionThese findings highlight the breadth of factors associated with OA in the MVP veteran population and suggest that physical status may be a modifiable risk factor for OA. This work may contribute to designing strategies to optimize appropriate detection, intervention, treatment, and even rehabilitation strategies for OA in veterans and the general population.