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Relationship of Pain, Function and Quality of Life with Disease Grading among Patients with Knee Osteoarthritis
Knee Osteoarthritis (KOA) is a global public health problem. The prevalence of KOA is on the rise leading to increased disease burden. Female and older adults have a higher risk of developing KOA. The diagnosis of KOA is usually based on specific clinical signs and symptoms or based on structural changes evident on radiographs. The clinical decision for management in these patients is based on X-ray grading. Recently there is a discussion on concordance between clinical and radiological findings in KAO patients. Therefore, it is necessary to identify a relationship between patient-reported findings and disease grading based on standard radiographs. This cross-sectional study recruited KAO patients from rural and urban parts of Phagwara and Jalandhar, Punjab, India. Participants were identified during medical and physiotherapy camps. Participants were included based on the American College of Rheumatology Criteria (ACR). Demographic characteristics, pain intensity, functional status, and Quality of Life (QOL) were assessed and documented. Disease grading was done based on presenting X-rays using grading proposed by Kellgren and Lawrence. The association between these variables was analyzed using R software and reported. We also predicted disease grading using QOL metrics. 120 Participants’ data were included in the final analysis. Findings suggest an association between demographic (age, height, weight and BMI) variables and disease grading. Pain, functional status, and QOL were found to be associated with disease grading. SF-Physical functioning and SF-General Health QOL metrics significantly predicted disease grading. The study’s findings suggest that disease grading based on X-rays shows an association with the participants’ clinical presentation.
Keywords
Disease Grading, Epidemiology, Osteoarthritis, Quality of Life, Radiography
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- James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N et al. Global, regional and national incidence, prevalence and years lived with disability for 354 diseases and injuries for 195 countries and territories. 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1789–858. https://doi.org/10.1016/ S0140-6736(18)32279-7
- Parsons C, Fuggle NR, Edwards MH, Goulston L, Litwic AE, Jagannath D et al. Concordance between clinical and radiographic evaluations of knee osteoarthritis. Aging Clin Exp Res. 2018; 30:17–25. PMid: 29101670 PMCid: PMC5785611. https://doi.org/10.1007/s40520-017-0847-z
- Safiri S, Kolahi AA, Smith E, Hill C, Bettampadi D, Mansournia MA et al. Global, regional and national burden of osteoarthritis 1990-2017: A systematic analysis of the Global Burden of Disease Study 2017. Ann Rheum Dis. 2020; annrheumdis-2019-216515. PMid: 32398285. https://doi.org/10.1136/annrheumdis-2019-216515
- Wood AM, Brock TM, Heil K, Holmes R, Weusten A. A review on the management of Hip and Knee Osteoarthritis. Int J Chronic Dis. 2013; 2013:1–10. PMid: 26464847 PMCid: PMC4590943. https://doi.org/10.1155/2013/845015
- Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of Knee Osteoarthritis in population-based studies. E Clinical Medicine. 2020; 29-30: 100587. PMCid: PMC7704420.https://doi.org/10.1016/j.eclinm.2020.100587
- Kellgren JH LJ. Radiological assessment of osteo-arthrosis. Annals of the Rheumatic Diseases. 1957 Dec; 16(4):494. Ann Rheum Dis. 1957; 16:494. PMid: 13498604 PMCid: PMC1006995. https://doi.org/10.1136/ard.16.4.494
- Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al. Development of criteria for the classification and reporting of osteoarthritis: Classification of osteoarthritis of the knee. Arthritis Rheum. 1986; 29:1039–49. PMid: 3741515. https://doi.org/10.1002/art.1780290816
- Zhang W, Doherty M, Peat G, Bierma-Zeinstra SMA, Arden NK, Bresnihan B et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis. 2010; 69:483–9. PMid: 19762361. https:// doi.org/10.1136/ard.2009.113100
- NICE. Overview | Osteoarthritis: care and management | Guidance | NICE. 2021 https://www.nice.org.uk/guidance/ cg177
- Wenham CYJ, Grainger AJ, Conaghan PG. The role of imaging modalities in the diagnosis, differential diagnosis and clinical assessment of peripheral joint osteoarthritis. Osteoarthr Cartil. 2014; 22:1692–702. PMid: 25278078. https://doi.org/10.1016/j.joca.2014.06.005
- Wang X, Oo WM, Linklater JM. What is the role of imaging in the clinical diagnosis of osteoarthritis and disease management? Rheumatol (United Kingdom). 2018; 57: iv51–iv60. PMid: 29351654. https://doi.org/10.1093/rheumatology/ kex501
- Sinusas K. Osteoarthritis: Diagnosis and treatment. Am Fam Physician. 2012; 85:49–56. https://doi.org/10.1007/ s15200-012-0678-0
- Bruyère O, Cooper C, Arden N, Branco J, Brandi ML, Herrero-Beaumont G et al. Can we identify patients with high risk of osteoarthritis progression who will respond to treatment? A Focus on Epidemiology and Phenotype of Osteoarthritis. Drugs and Aging. 2015; 32:179–87. PMid: 25701074 PMCid: PMC4366553. https://doi.org/10.1007/s40266-015-0243-3
- Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA et al. OARSI guidelines for the non-surgical management of knee, hip and polyarticular osteoarthritis. Osteoarthr Cartil. 2019; 27:1578–89. PMid: 31278997. https://doi.org/10.1016/j.joca.2019.06.011
- Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J et al. 2019 American College of Rheumatology/ Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip and Knee. Arthritis Rheumatol. 2020; 72:220–33. PMid: 31908163. https://doi. org/10.1002/art.41142
- Schmitt J, Lange T, Günther KP, Kopkow C, Rataj E, Apfelbacher C, et al. Indication criteria for total knee arthroplasty in patients with osteoarthritis - A multi-perspective consensus study. Z Orthop Unfall. 2017; 155:539–48. PMid: 29050054. https://doi.org/10.1055/s-0043-115120
- Nikolic G, Nedeljkovic B, Trajkovic G, Rasic D, Mirkovic Z, Pajovic S et al. Pain, physical function, radiographic features, and quality of life in Knee Osteoarthritis agricultural workers living in rural population. Pain Res Manag. 2019; 2019. PMid: 31662813 PMCid: PMC6791194 https://doi.org/10.1155/2019/7684762
- Parsons C, Clynes M, Syddall H, Jagannath D, Litwic A, van der Pas S, et al. How well do radiographic, clinical and self-reported diagnoses of Knee Osteoarthritis agree? Findings from the Hertfordshire cohort study. Springerplus .2015; 4. PMid: 25932366 PMCid: PMC4408304. https:// doi.org/10.1186/s40064-015-0949-z
- World Medical Association. World Medical Association Declaration of Helsinki. JAMA 2013; 310:2191. PMid: 24141714. https://doi.org/10.1001/jama.2013.281053
- Shirley Ryan Ability Lab. Numeric Pain Rating Scale | Rehab Measures Database. 2021. https://www.sralab.org/ rehabilitation-measures/numeric-pain-rating
- McConnell S, Kolopack P, Davis AM. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): A review of its utility and measurement properties. Arthritis Care Res. 2001; 45:453–61. https:// doi.org/10.1002/1529-0131(200110)45:5<453::AIDART365> 3.0.CO;2-W
- Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988.
- Shirley Ryan Ability Lab. Western Ontario and McMaster Universities Osteoarthritis Index | Rehab Measures Database. 2021 Feb. https://www.sralab.org/ rehabilitation-measures/womac-osteoarthritis-index-reliabilityvalidity-and-responsiveness-patients
- Laucis NC, Hays RD, Bhattacharyya T. Scoring the SF-36 in orthopaedics: A brief guide. J Bone Jt Surg – Am. 2014; 97:1628–34. PMid: 26446970 PMCid: PMC5029523. https://doi.org/10.2106/JBJS.O.00030
- RAND. 36-Item Short Form Survey (SF-36) Scoring Instructions | RAND. 2021 Feb. https://www.rand.org/ health-care/surveys_tools/mos/36-item-short-form/scoring.html
- Benjamini Y, Hochberg Y. Controlling the false discovery rate: A practical and powerful approach to multiple testing. J R Stat Soc Ser B. 1995; 57:289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x
- Hays RD, Sherbourne CD, Mazel RM. The rand 36‐item health survey 1.0. Health Econ. 1993; 2:217–27. PMid: 8275167. https://doi.org/10.1002/hec.4730020305
- Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature. BMC Musculoskelet Disord. 2008; 9:116. PMid: 18764949 PMCid: PMC2542996. https://doi.org/10.1186/1471-2474-9-116
- Lethbridge‐Cejku M, Scott WW, Reichle R, Ettinger WH, Zonderman A, Costa P et al. Association of radiographic features of osteoarthritis of the knee with knee pain: Data from the baltimore longitudinal study of aging. Arthritis Rheum. 1995; 8:182–8. PMid: 7654803. https://doi.org/10.1002/art.1790080311
- Cruz-Almeida Y, Sibille KT, Goodin BR, Petrov ME, Bartley EJ, Riley JL et al. Racial and ethnic differences in older adults with knee osteoarthritis. Arthritis Rheumatol. 2014; 66:1800–10. PMid: 24729357 PMCid: PMC4077911. https://doi.org/10.1002/art.38620
- Chia YC, Beh HC, Ng CJ, Teng CL, Hanafi NS, Choo WY, et al. Ethnic differences in the prevalence of knee pain among adults of a community in a cross-sectional study. BMJ Open. 2016; 6:e011925. PMid: 27909033 PMCid: PMC5168635. https://doi.org/10.1136/bmjopen-2016-011925
- Herman A, Chechik O, Segal G, Kosashvili Y, Lador R, Salai M, et al. The correlation between radiographic knee OA and clinical symptoms-do we know everything? Clin Rheumatol. 2015; 34:1955–60. PMid: 25604319. https://doi.org/10.1007/s10067-015-2871-8
- Creamer P, Lethbridge-Cejku M, Hochberg MC. Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology. 2000; 39:490–6. PMid: 10852978. https://doi.org/10.1093/rheumatology/39.5.490
- Muraki S, Akune T, Oka H, En-yo Y, Yoshida M, Saika A, et al. Association of radiographic and symptomatic Knee Osteoarthritis with health-related quality of life in a population- based cohort study in Japan: The ROAD study. Osteoarthr Cartil. 2010; 18:1227–34. PMid: 20633679. https://doi.org/10.1016/j.joca.2010.06.001
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