LAUSR

MHT for use of MHT 12 months. Covariates that were M usculoskeletal joint pains and arthritis are more common in women, and their frequency can increase with age. Osteoarthritis (OA), the most common form of degenerative arthritis, is a leading cause of disability with high physical, psychological, and socioeconomic burden. Some women have an increase in joint pains with the onset of menopause and an increased prevalence of OA after menopause has been reported. OA pathogenesis is poorly understood and there are no disease-modifying osteoarthritis drugs (DMOADs) available. Studies to investigate effects of estrogen and estrogen receptors in joint tissues to potentially prevent development or progression of OA have been pursued but with inconsistent results. Lack of estrogen in animal models has been shown to accelerate cartilage damage. In the literature, there has long been a suggested association and perhaps causal link in reduced estrogen or estrogen deficiency to an increase in joint pain or symptomatic arthritis; however, few studies have looked at menopausal hormonal therapy (MHT) specifically for its impact on knee OA, the most common type of osteoarthritis. Interest in estrogen as a potential modifier of the progression of OA has been based on its known anti-inflammatory effect at high concentrations and role in cartilage preservation. In this issue, Jung et al add to our understanding of the relationship of hormonal changes in women, hormonal therapies, and knee osteoarthritis. This study was a large nationwide cross-sectional observational study of 4,766 postmenopausal Korean women over 50 years of age who had undergone knee joint radiography, and completed the Korea National Health and Nutrition Examination Survey (2009-2012). It aimed to assess the association between knee OA prevalence and MHT. MHT use was collected and duration of use was measured in months. Participants were assigned to the