Associate Professor CFM Department AIIMS BIBINAGAR HYDERABAD, Telangana, India
Objectives : To assess the association between fluoride biomarkers (serum, urine, drinking water) and radiographic severity of knee OA in adults from a fluorosis-endemic region of Telangana, India.
Design: In this cross-sectional study, 119 adults with radiologically confirmed knee OA were evaluated. Fluoride levels in serum, urine, and drinking water were measured. OA severity was assessed using the Kellgren-Lawrence (KL) grading, Visual Analog Scale (VAS) for pain, and Knee Injury and Osteoarthritis Outcome Score (KOOS) for function.
Results: Moderate-to-severe OA (KL grade 3-4) was present in 50.4% of participants. These individuals showed significantly higher serum fluoride levels (p = 0.007). Use of untreated underground water was associated with increased OA severity (OR: 3.6; 95% CI: 1.3–10.1). Participants using reverse osmosis (RO) water filtration had significantly lower pain (p = 0.02) and better functional scores (p = 0.05).
Conclusion: Higher fluoride exposure, particularly via serum biomarkers and untreated underground water, is significantly associated with advanced OA severity. Public health strategies ensuring access to safe water and fluoride monitoring could help mitigate OA burden in endemic regions.
