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Cross-sectional surveys of health-related quality of life (QOL) in subjects with low back pain and knee pain using a population-based cohort.The purpose of the present study was to clarify the impact of low back pain and knee pain on QOL in men. In addition, we analyzed the impacts of vertebral fracture (VFx), lumbar spondylosis, and knee osteoarthritis (OA) on the magnitude of QOL loss in men with low back pain and knee pain.Low back pain and knee pain are major public health issues causing disability among the elderly men, but there were no population-based studies to compare the impact of low back pain on QOL with that of knee pain in Japanese men.From 3040 participants in the Research on Osteoarthritis Against Disability study, data from 767 men older than 40 years who completed questionnaires (mean age = 69.7 years) were examined. To carry out the QOL assessment, the Medical Outcomes Study Short Form 8 (SF-8) and EuroQol (EQ-5D) were used. We examined the association of low back pain and knee pain with QOL. Furthermore, we also examined the presence of VFx and the severity of lumbar spondylosis and knee OA with the magnitude of QOL loss in men with low back pain and knee pain, respectively.The impact of low back pain on QOL was larger than that of knee pain. In men with low back pain, there were few associations between Kellgren-Lawrence grade and QOL, whereas VFx was associated with physical QOL. For men with knee pain, Kellgren-Lawrence grade equal to 4 knee OA was associated with QOL.This study revealed that low back pain has a larger impact than knee pain on QOL. Furthermore, low back pain with VFx is strongly associated with physical QOL loss.