Q&A: Examining the link between physical activity and hip osteoarthritis

[ Back to main article ]

Dr. John Esdaile
Arthritis Research Centre of Canada
University of British Columbia
University of Calgary

Arthritis ('arth' meaning joint, 'itis' meaning inflammation) isn't a one-note story or even a few variations on a single theme; it actually consists of more than 100 different conditions. These can be anything from relatively mild forms of tendinitis (as in 'tennis elbow') and bursitis to crippling systemic forms, such as rheumatoid arthritis (Source: The Arthritis Society).

Osteoarthritis (OA) is the most common form of arthritis affecting about 1 in 10 Canadians. It occurs when the cartilage is damaged. After a patient is diagnosed with osteoarthritis, they wonder what they can do. Proper nutrition and exercise are important for people with arthritis in order to manage their symptoms. It helps reduce pain and improves joint flexibility.

OA is the most common form of hip arthritis which is responsible for more than 90% of hip replacements. Recently, subtle deformities of the hip have been linked to hip OA. It is believed that certain types of physical activity such as hockey, soccer and bicycling combined with the deformity causes damage to the hip. Dr. John Esdaile, Scientific Director of the Arthritis Research Centre of Canada is leading a research team that hopes to get some answers showing how physical activity while interacting with one or more subtle deformities can cause cartilage damage and eventually OA.

Dr. Esdaile talks about his research below.

IMHA: How long have you been involved in arthritis research and what first led you to become interested in it?

JE: I have been working in arthritis research for over 30 years now. My interest arose when I first started my training as a clinical immunologist at McGill University. I was interested in immune complex diseases such as vasculitis and systemic lupus erythematosus.

IMHA: What is your particular area of interest?

JE: Over the last three decades my research interests have included systemic lupus erythematosus, rheumatoid arthritis and osteoarthritis of the hip and knee.

IMHA: Briefly, what research are you currently working on?

JE: I am the Scientific Director of the Arthritis Research Centre in Canada. My colleagues and I are leading a 5-year, $2.5 million project – the IMPAKT-HiP study – funded by the Canadian Institutes of Health Research on hip pain and its link to osteoarthritis. Our goal is to show how physical activity while interacting with one or more subtle deformities of the hip bone can cause cartilage damage and eventually OA. We believe this may open the door to preventing hip osteoarthritis, which means we avoid costly surgery and greatly improve the quality of life of Canadians who experience hip pain.

IMHA: What are the goals of your work, in terms of changing arthritis research directions and how research may affect treatment of arthritis patients?

JE: The major focus has been on the ability of early recognition and early intervention to dramatically alter outcome. When I started in rheumatology, this concept did not exist.

IMHA: Are you currently working on research involving physical activity and arthritis?

JE: In addition to the IMPAKT-HiP study, I was part of a team, led by Dr. Carlo Marra, that carried out a study involving 190 patients who had early knee OA that had not yet been medically diagnosed. We found our simple but all encompassing program led to exercising more, losing weight and dramatic pain relief six months after starting the program.

More recently, I worked with my colleagues, Drs. Chuck Ratzlaff and Jacek Kopec, on a study showing that significant impact of extreme levels of lifetime physical activity on the development of hip and knee osteoarthritis.

IMHA: What do you do when you have time off? What is your favourite physical activity?

JE: When I have time off I like to read, play tennis and go warm ocean swimming.