title: Association between index-to-ring finger length ratio and risk of severe knee and hip osteoarthritis requiring total joint replacement.
abstract: OBJECTIVE
  The data are conflicting for the association between the index-to-ring finger length ratio (2D:4D) and the risk of OA. The aim of this cohort study was to examine the relationship between 2D:4D and the risk of severe knee and hip OA requiring total joint replacement.
  
  
  METHODS
  A total of 14 511 participants in the Melbourne Collaborative Cohort Study had 2D:4D assessed from hand photocopies. The incidence of total knee replacement and total hip replacement between 2001 and 2011 was determined by linking the cohort records to the Australian Orthopaedic Association National Joint Replacement Registry.
  
  
  RESULTS
  Over an average 10.5 years of follow-up, 580 participants had total knee replacement and 499 had total hip replacement. Greater right 2D:4D [hazard ratio (HR) 0.91 for a s.d. increase in 2D:4D, 95% CI 0.84, 0.99, P = 0.03] and average right and left 2D:4D (HR 0.91 for a s.d. increase in 2D:4D, 95% CI 0.84, 0.99, P = 0.02) were associated with a reduced incidence of total knee replacement. These associations persisted when participants whose fingers had any features that might have affected the validity of 2D:4D measurements were excluded. No significant associations were observed between 2D:4D and the incidence of total hip replacement.
  
  
  CONCLUSIONS
  A lower 2D:4D is associated with an increased risk of severe knee OA requiring total knee replacement, but not the risk of severe hip OA. The underlying mechanisms for the association warrant further investigation.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Sultana Monira
authors.initials: SM
authors.lastname: Hussain
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia. yuanyuan.wang@monash.edu.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Muller
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Anita E
authors.initials: AE
authors.lastname: Wluka
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adel
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: John T
authors.initials: JT
authors.lastname: Manning
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Graves
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Victoria, Australia, Department of Psychology, University of Swansea, Swansea, UK, Department of Orthopaedic, Repatriation General Hospital, Daw Park and AOA National Joint Replacement Registry, Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Flavia M
authors.initials: FM
authors.lastname: Cicuttini
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005385:Fingers / Q000033:anatomy & histology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000453:epidemiology* / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000453:epidemiology* / Q000601:surgery; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: index-to-ring finger length ratio; osteoarthritis; total hip replacement; total knee replacement