Out of hand: prevalence and joint patterning of hand and wrist osteoarthritis in medieval Dutch populations

Abstract

Introduction

Osteoarthritis (OA) is a common disease that degrades the cartilage in synovial joints, eventually leading to the direct destruction of bone. Today, OA is often observed in the hands and wrists, yet there have been few dedicated studies in past populations. This research aims to investigate how the living environment impacts the occurrence and patterning of hand and wrist OA in the medieval Netherlands.

Materials & Methods The skeletal remains of 226 adult individuals from three sites (urban Alkmaar, rural Klaaskinderkerke, and urban hospital Kampen) were analysed to shed light on past prevalence and variation in affected joints between contextually different populations. The operational definition from Waldron (2009) was used to diagnose OA. Results Expectedly, a significant relationship between age and OA prevalence was found, χ2(2, N=226)=26.72, p<.001), with older individuals being more affected. Sex did not influence OA prevalence, χ2(2, N=226)=.75, p=0.68). Interestingly, even though the age distribution between the sites was similar, a clear interpopulation difference in overall hand and wrist OA prevalence was observed: hospital (32%), urban (12%) and rural (5%). Joint-specific patterning also showed variation between the sites, with OA predominance in the lateral wrist (thumb-base/wrist joint complex) in the urban hospital population, and in the medial wrist (piso-triquetral) in the urban population. Conclusions These results suggest that population context plays a significant role in OA occurrence. Differences in OA prevalence and patterning may suggest different activities or risk factors depending on the environment, which need to be explored further and on a larger scale.