The Drug ‘Metformin’ can Guard You Against Knee Osteoarthritis

The researchers examined the link between frequent metformin use and total knee replacement in diabetic patients. In this retrospective research using computerized records from Hong Kong public primary care, patients with diabetes aged 45 who attended from 2007 to 2010 were followed up for four years from 2011 to 2014 to determine the incidence of total knee replacement.

Knee osteoarthritis is the most frequent type of chronic arthritis and a major cause of pain and impairment around the world. The global age-standardized point prevalence and annual incidence rate of osteoarthritis in 2017 were 3754.2 and 181.2 per 100,000, respectively, according to the Global Burden of Disease study. Individuals with knee OA experience increased pain, activity limits, psychological discomfort, and a significantly lower quality of life (


There were 184 total knee replacements among 46,665 frequent users, 17.1% fewer than among non-users.

Link Between Metformin and Osteoarthritis

Findings show a potential preventive impact of metformin on knee osteoarthritis progression and later total knee replacement incidence among diabetes patients.
Osteoarthritis is a common chronic ailment that usually causes joint discomfort and can be severe enough to require knee and hip replacements. Total knee and total hip replacement surgeries in the United States are expected to reach 5,72,000 per year by 2030. There are currently no drugs that can prevent or reverse osteoarthritis.


A group of researchers from China, Taiwan, and Australia set out to see if metformin use was connected with a lower risk of total knee or total hip replacement, as the evidence has been scant and equivocal thus far. They compared the risk of total knee and/or total hip replacement between metformin users and non-users in 69,706 Taiwanese people diagnosed with type 2 diabetes between 2000 and 2012. The average age was 63, and half of the participants were female. Osteoarthritis was responsible for almost 90% of total joint replacements (2 Trusted Source
Metformin use and the risk of total knee replacement among diabetic patients: a propensity-score-matched retrospective cohort study

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“We found that metformin use in patients with type 2 diabetes mellitus was associated with a significantly reduced risk of joint replacement, suggesting a potential therapeutic effect of metformin in patients with osteoarthritis,” writes Dr. Changhai Ding, Clinical Research Center of Zhujiang Hospital, Southern Medical University, Guangzhou, China.

Despite the low occurrence of total knee replacement and a relatively short 4-year follow-up period, we discovered a significant statistical reduction of 19% in the rate of TKR in a diabetic population who are regular metformin users compared to non-users, with an obvious dose-response relationship.

The prevalence of total knee replacement suggests a potential slowing of osteoarthritis disease progression in type 2 diabetes patients who take metformin regularly. With the predicted biological effects on meta-inflammation and weight loss, metformin may be repurposed as a disease-modifying medication for individuals with knee osteoarthritis. A future study should include longer follow-up studies, a more specific selection of individuals with preexisting diagnoses of knee OA and its severity, and metformin dosage information.

Reference :

  1. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017 – (
  2. Metformin use and the risk of total knee replacement among diabetic patients: a propensity-score-matched retrospective cohort study – (

Source: Medindia

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