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Increased risk of osteoarthritis in persons with spinal cord injury: a population-based longitudinal follow-up study in Taiwan

Spinal Cord volume 63, pages 508–513 (2025)Cite this article

Subjects

Abstract

Study design

Retrospective cohort study.

Objectives

To assess the relative risk of osteoarthritis (OA) in individuals with newly diagnosed spinal cord injury (SCI) compared to a matched non-SCI group.

Setting

Taiwan’s Longitudinal Health Insurance Database.

Methods

We identified 1373 individuals aged 20–69 years with newly diagnosed SCI between 2002 and 2005 as the SCI group. A propensity-score-matched non-SCI group (N = 5492) with similar baseline demographic and clinical characteristics was selected for comparison. Both groups were followed until December 2011. OA-free survival was analyzed via Kaplan-Meier curves, and the association between SCI and OA risk was evaluated via stratified Cox proportional-hazards regression. To assess temporal risk variations, we performed landmark analysis with a 1-year cutoff, dividing follow-up into early (0–1 year) and long-term (≥1 year) periods.

Results

The respective incidence rates of OA for the SCI and non-SCI groups were 45.4 per 1000 person-years (95% confidence interval [CI], 40.1–50.1) and 31.6 per 1000 person-years (95% CI, 29.8–33.4). The hazard ratio of OA for the SCI group, as compared to the non-SCI group, was 1.52 (95% CI 1.34–1.72, p < 0.0001).

Conclusions

This population-based longitudinal follow-up study indicates that there is an increased long-term risk of OA in persons with SCI, underscoring the need for clinical vigilance and early diagnostic measures in this population. Further research is needed to explore the mechanisms underlying the association between these two conditions.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

This work was supported by grant MOST 109-2314-B-002-117 from the Ministry of Science and Technology, Executive Yuan, Republic of China, and Good Liver Foundation. However, the funders had no role in the study’s design, data collection, or analysis; the decision to publish it; or the preparation of the manuscript.

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan

    Chien-Po Liu & Shin-Liang Pan

  2. Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan

    Shin-Liang Pan

Authors
  1. Chien-Po Liu
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  2. Shin-Liang Pan
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Contributions

CPL contributed to study design, data analysis, manuscript drafting, and revision. SLP contributed to study design, data analysis, manuscript drafting, and revision. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shin-Liang Pan.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

This study was approved by the Research Ethics Committee of National Taiwan University Hospital. The approval number is 201912207RIND. All methods were performed in accordance with the relevant institutional and governmental guidelines and regulations. All individuals’ data were encrypted to protect individual privacy and allow for anonymous analysis. Therefore, it obviated the need for informed consent as the database consists of de-identified data intended for research use.

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Liu, CP., Pan, SL. Increased risk of osteoarthritis in persons with spinal cord injury: a population-based longitudinal follow-up study in Taiwan. Spinal Cord 63, 508–513 (2025). https://doi.org/10.1038/s41393-025-01112-x

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