Associate Director, Centre for Orthopaedics, BLK-Max Super Speciality Hospital, New Delhi
Part 3 of 11 in Diagnosis and Management of Arthritis in Joints
Who Is at Risk of Osteoarthritis: Age, Weight, Occupation and Injury
September 6, 2026
Osteoarthritis does not strike at random. Dr. Mannu Bhatia listed the factors that push a joint toward earlier, more severe wear, several of which are within a patient's own control.
Age, weight and genetics
Age is the most direct risk factor, since cartilage naturally wears down over decades of use. Obesity adds mechanical load to weight-bearing joints such as the knee and hip, and genetics also plays a role in how quickly cartilage degenerates.
Occupational and sporting hazards
People who use their limbs aggressively and repeatedly over years, such as army personnel, police officers and competitive sportsmen, are more prone to joint arthritis than the general population. Dr. Bhatia also pointed to sports injuries, particularly meniscal tears and ACL injuries, as a frequent and often ignored risk factor in Africa, where such injuries are common but patients often do not seek treatment for them.
Why early recognition matters
Dr. Bhatia's central message on risk was practical rather than theoretical: recognising joint disease at an early stage is what allows a patient to avoid the much larger problem of advanced arthritis later. A meniscal or ligament injury left untreated does not stay contained; left alone, it progresses toward the same cartilage breakdown that defines osteoarthritis.
This article is based on a Jivo Masterclass session conducted by Dr. Mannu Bhatia, Associate Director, Centre for Orthopaedics, BLK-Max Super Speciality Hospital, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Mannu Bhatia taught doctors across Africa on February 2, 2025.
FROM THE LIVE Q&A
Moderator
What are the absolute contraindications for joint replacement?
Dr. Mannu Bhatia
As surgical techniques progress, more countries are attempting these surgeries, but two things need to be in place regardless: a genuinely sterile operating theatre, and excellent post-operative facilities, since that is what actually gets the patient the benefit of the surgery. There are no absolute contraindications beyond the patient having a poor overall medical condition, for example a cardiac condition that would make operating on them risky.
Frequently Asked Questions
Is it possible to do a bilateral hip replacement in a patient with a slipped hip joint?▼
Bilateral hip replacement can always be done, either in the same sitting or with a gap between the two sides, depending on the patient's condition. If the body can tolerate it, both sides can be done together. If the body, or the finances, don't allow that, there can be a gap in between, but rehabilitation and the expected result need to be planned accordingly.
What is the best NSAID to use for osteoarthritis?▼
I would not advise continuous use of NSAIDs, since they can have a harmful effect on the kidneys over time. Short-term use for pain relief is fine.
How affordable are these surgeries at your facility?▼
They are very affordable in India, around half the cost of the same surgery in Nigeria, and much less than the cost in Europe or the US, with better results.
What is the definitive treatment for osteoarthritis?▼
The definitive treatment is that the patient should be visiting the doctor regularly. If the condition is detected and treated at an early stage, that is the definitive treatment. A patient who ignores an ACL injury, skips the recommended MRI, skips the recommended surgery and skips the medicines is the one who progresses to osteoarthritis and eventually needs a knee replacement. Patients with a problem in one knee who don't get it treated often go on to develop the same problem in the other knee, then the hips, then the spine. The definitive treatment is listening to the doctor and following through, whether that means physiotherapy or treatment for rheumatoid arthritis.
I have a patient with intermittent elbow pain, treated with oral and topical NSAIDs followed by PRP injections. What is the outcome of PRP for this patient in Ethiopia?▼
I am not a strong advocate for PRP. Once the joint surface and the cartilage are already gone, PRP cannot regenerate them, so I don't believe it delivers a real result. I would want to see the patient's X-rays, and an MRI if needed, before deciding what should actually be done.
What raises a person's risk of osteoarthritis?▼
Age, obesity, genetics, prior joint injury, and occupations or sports that place repeated heavy load on the joints, such as military service, policing and competitive sport.
Why does Dr. Bhatia emphasise early treatment of sports injuries?▼
Meniscal tears and ACL injuries are often ignored, especially in Africa, but left untreated they progress toward the cartilage breakdown that causes osteoarthritis later in life.
In This Series: Diagnosis and Management of Arthritis in Joints
- 1.Diagnosis and Management of Arthritis in Joints
- 2.What Is Arthritis? Understanding Its Main Types and Causes
- 3.Who Is at Risk of Osteoarthritis: Age, Weight, Occupation and Injury
- 4.Recognising Joint Arthritis: Pain, Swelling, Crepitus and Instability
- 5.Diagnosing Joint Arthritis: Why X-Rays Come Before an MRI
- 6.Non-Surgical Management of Arthritis: Weight, Physiotherapy and Mobility Aids
- 7.Medicines and Joint Injections for Arthritis: What Works and What Doesn't
- 8.When Arthritis Needs Surgery: Hip, Knee, Shoulder and Elbow Replacement
- 9.Recovery After Joint Replacement: Rehabilitation and Activity Limits
- 10.Joint Replacement Case Studies: Patients Who Travelled From Africa for Surgery
- 11.The Cost of Joint Replacement Surgery in India for International Patients