The drug ‘Metformin’ may protect you against osteoarthritis of the knee

Researchers examined the link between regular metformin use and total knee replacement in diabetics. In this retrospective study using computerized records from the public primary care service in Hong Kong, 45-year-old diabetic patients participating from 2007 to 2010 were followed for four years. years from 2011 to 2014 to determine total knee replacement rates.

Osteoarthritis of the knee is the most common type of chronic arthritis and a major cause of pain and weakness worldwide. According to the Global Burden of Disease Study, the global age-standardized score prevalence and the annual incidence of osteoarthritis in 2017 were 3754.2 and 181.2 per 100,000, respectively. People with OA of the knee experience increased pain, limited activity, psychological discomfort, and a significantly lower quality of life (


There were a total of 184 knee replacements among 46,665 regular users, 17.1% less than non-users.

The Link Between Metformin and Osteoarthritis

The findings suggest a potential preventive impact of metformin on the progression of osteoarthritis of the knee and later total knee replacement rates in patients with diabetes. Osteoarthritis is a common chronic disease that often causes joint discomfort and can be so severe that knee and hip replacements are required. The total number of total knee and hip replacement surgeries in the United States is expected to reach 572,000 per year by 2030. There are currently no drugs that can prevent or reverse osteoarthritis.


A team of researchers from China, Taiwan, and Australia set out to investigate whether metformin use was associated with a reduced risk of total knee or total hip replacement, as until now. The evidence is still scant and unclear. They compared the risk of total knee and/or total hip replacement between metformin users and nonusers in 69,706 Taiwanese diagnosed with type 2 diabetes between 2000 and 2012. The average age was 63 and half of the participants were female. Osteoarthritis is responsible for nearly 90% of all joint replacements (2 Trusted Source
Metformin use and risk of total knee replacement in patients with diabetes mellitus: a prospective score-matched retrospective cohort study.

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

Despite the low rate of total knee replacement and the relatively short 4-year follow-up, we found a statistically significant reduction in TKR rates of 19% in the diabetic group using regular metformin versus nonusers, with a clear dose-response relationship.

Total knee replacement rates have shown potential to slow the progression of osteoarthritis in type 2 diabetics taking metformin regularly. Given the predicted biological effects on meta-inflammation and weight loss, metformin could be repurposed as a disease-modifying drug for people with knee osteoarthritis. A future study should include longer follow-up studies, more specifically selecting individuals with a pre-existing diagnosis of knee arthritis and its severity, as well as metformin dosing information.

Authority to solve :

  1. Global, regional and national degenerative joint disease burden 1990-2017: a systematic analysis of the 2017 Global Burden of Disease Study – (
  2. Metformin use and risk of total knee replacement in patients with diabetes: a retrospective cohort study with propensity scores – (

Source: Medindia


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