BACKGROUND: Researchers have long been interested in the potential relationship between osteoarthritis (OA), falls, and fractures
however, the evidence supporting this relationship has been conflicting. This study aimed to investigate the association between osteoarthritis and future fracture events. MATERIALS AND METHODS: This study was designed as a prospective cohort study. We recruited a total of 440 476 individuals from the UK Biobank to investigate the impact of OA on the incidence of fracture. Among the total population, there were 54 581 participants diagnosed with OA. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS: A total of 26 083 fracture events were documented over a median follow-up period of 13.5 years. After multivariable adjustment, participants with osteoarthritis had an HR (95% CI) of 1.11 (1.08, 1.15) for future fracture events compared to participants without osteoarthritis ( P <
0.0001). Falls explained 16.34% of the association between osteoarthritis and fracture events and 14.15% of the association between knee osteoarthritis and fracture events. The association was not substantially altered across the series of sensitivity analyses. CONCLUSION: Osteoarthritis was associated with a greater risk of future fracture events. This finding highlights the importance of preventing future fracture events in people with osteoarthritis.