Musculoskeletal Epidemiology

The work of the Musculoskeletal Epidemiology Unit centres on the development of outcome methods in musculoskeletal disease and the application of these methods in the prevention and management of musculoskeletal disease.

Head of Unit

Professor Flavia Cicuttini
Phone: +61 3 9903 0158
Fax: +61 3 9903 0556


Professor Anita Wluka MBBS, PhD, FRACP
Associate Professor Donna Urquhart BPhysio(Hons), PhD
Dr Monira Hussain MBBS, MPH, PhD
Dr Yuanyuan Wang MM, PhD
Ms Molly Bond
Ms Aruna Kartik

PhD Students

Mrs Bothaina Al Yousef
Dr Sharmayne Brady
Dr Louisa Chou
Ms Yuan Zhi Lim
Mr Waruna Peiris


Are low perimenopausal testosterone levels a predictor of osteoarthritis in women?

There are no treatments available that affect the development of osteoarthritis (OA). OA is a common disease and will become an increasing economic burden as the population ages. Prevention must play a major role in managing this disease. Little data is available on the effect of testosterone on joint cartilage or osteoarthritis despite its well characterized effect on other tissues in the musculoskeletal system. However there are some very intriguing findings suggesting that testosterone may have a beneficial effect of knee cartilage. The aim of our study is to determine whether low perimenopausal testosterone levels are a predictor of osteoarthritis 10 years later and to examine the interaction between oestrogen and testosterone levels in development of osteoarthritis at the hands and knees at 10 years.

The effect of modifiable behavioural factors (diet, physical activity and use of hormone replacement) on knee cartilage

This study aims to identify life-style factors that effect knee cartilage volume in healthy subjects, thereby identifying potential targets for prevention of osteoarthritis. This will be done by utilizing an existing cohort (Melbourne Collaborative Cohort Study) and recently developed methodology for measuring articular cartilage volume. Osteoarthritis (OA), a disease where joint wear out, and for which there is no treatment that effects disease progression, has been described by the WHO as a potential epidemic and a major health and care services cost driver in an aging society. OA has the largest impact on burden of disease borne in later life and is the major reason for people needing joint replacements. This has been acknowledged by its listing as the 7th health priority in Australia. By identifying modifiable risk factors that have the potential to affect OA disease we will provide the opportunity to promote a better quality of life as people age.

Factors influencing longitudinal change in knee cartilage in healthy men

Osteoarthritis (OA) is a disease of joints, involving both cartilage and bone in the disease process. In this study we are following a cohort of healthy middle-aged men with no symptoms of knee OA to examine change in tibial cartilage over 2 years, and to examine factors, which may affect change.

Are knee cartilage defects associated with knee cartilage loss in healthy, middle-aged adults?

The significance of asymptomatic knee cartilage defects in healthy individuals in not known. The aim of this study is to examine the association between cartilage defects in the knee and cartilage volume both cross-sectionally and longitudinally in healthy, middle-aged adults. If cartilage defects are shown to be a risk factor for cartilage loss then interventions aimed at reducing or reversing cartilage defects may reduce the risk of developing knee OA.

The relationship between knee kinematics during walking and the patella cartilage and bone volume in healthy women

The influence exerted on cartilage and bone volume by locomotor patterns is poorly understood, particularly at the patellofemoral joint. The aim of this study is to investigate the associations between knee kinematics during gait and patella cartilage and bone volume. Understanding the effect of mechanical load exerted on the patella during walking may help our understanding of the pathogenesis of patellofemoral osteoarthritis.

What effect do dietary antioxidants have on the symptoms and structural progression of knee osteoarthritis over 2 years?

It has been suggested that antioxidant intake may be associated with less progression of radiographic knee osteoarthritis (OA). We are following a cohort of people with knee OA to determine the effect of dietary antioxidants on symptoms and cartilage volume in knee OA over 2 years.

Does oestrogen replacement therapy (ORT) prevent osteoarthritis?

There is no treatment available that effects progression of OA. Oestrogen replacement therapy has already been shown to be important in reducing the risk of cardiovascular disease and fracture rate in women. If hormone replacement therapy protects against loss of joint cartilage, this would be a potentially important preventive treatment for OA which is a very disabling condition that affects about 30% of women aged over 65 years. The aim of this study is to determine whether oestrogen replacement therapy protects against loss of knee joint cartilage in normal women over 2 years.


  • MPH coordination
  • Epidemiology and Biostatistics (Grad Diploma of Pharmaco-economics) by Distance Mode
  • Introduction Epidemiology (MPH)
  • Research Methods (MPH)


  • NHMRC Career Development Grants
  • NHMRC Research Fellowships Advisory Panel
  • Royal Australasian College of Physicians Research Advisory Committee
  • Jacquot Selection Committee, RACP
  • Arthritis Foundation Research Committee
  • OARSI study group on hand OA
  • Working group for MRI in the NIH OA Initiative
  • AstraZeneca International OA Advisary Board
  • Content review committee Medical Journal of Australia

The Musculoskeletal Epidemiology Unit, through key personnel, is also an active participant in two NHMRC Centres of Clinical Research Excellence:

NHMRC Centre of Clinical Research Excellence in Therapeutics – based at the School of Public Health and Preventive Medicine, this is a collaborative venture between Monash University and the Alfred Hospital, providing a national resource for evaluation of the efficacy of new and existing therapeutic agents.

NHMRC Centre of Clinical Research Excellence in Women's Health – based at the Jean Hailes Foundation, Clayton, Victoria, this CRE will provide an opportunity for comprehensive and multidisciplinary research into the role of oestrogens and androgens in these disorders.