Leung YY, et al. – Among 35,298 Chinese women aged 45-74 years who were recruited to the Singapore Chinese Health Study from 1993 to 1998, researchers assessed the risk of total knee replacement (TKR) due to severe knee OA and its potential association with reproductive or hormonal factors. They noted that higher parity, earlier age of menarche, and use of oral contraceptives were linked to increased TKR risk for severe knee OA among women. The highest risk was among women with ≥ 5 children vs nulliparous women. In addition, parity’s impact on the risk of TKR was much stronger among lean women vs heavier women. They investigators, however, did not observe any relationship between age at menopause and the use of hormonal therapy and TKR risk.