Osteoarthritis in Young Adults

Prevalence and Risk Factors

The American Geriatrics Society suggests that osteoarthritis (OA) can occur in younger adults, with nearly 50% of people developing symptomatic knee OA by age 85, and genetic predisposition being a significant risk factor, with heritability estimates of 0.39-0.65 1
Obesity is a risk factor that may contribute to early-onset OA 2, 3
Heavy physical activity or occupational stress, muscle weakness, particularly quadriceps weakness, and reduced joint proprioception are also risk factors for early-onset OA 3
Joint malalignment or biomechanical abnormalities are additional risk factors for OA 1

The American College of Radiology recommends that MRI is more sensitive than radiography for detecting early osteoarthritic changes and may be indicated when symptoms are not fully explained by radiographic findings 4
In patients under 70, structural abnormalities that are unilateral on imaging have a higher correlation with pain 4
Diagnostic evaluation should rule out other causes of knee pain in young adults, such as osteochondritis dissecans or meniscal tears 4

The American Geriatrics Society suggests that exercise programs that strengthen muscles, particularly quadriceps, are essential as muscle weakness is both a risk factor and consequence of OA 2, 3
Weight management for those who are overweight or obese is crucial 2, 3
Joint protection education and biomechanical corrections, as well as non-pharmacological interventions combined with medications, are recommended 3
Failing to address modifiable risk factors such as obesity, muscle weakness, and biomechanical issues can be a common pitfall in managing young adult OA 3