1. Disability in end-stage knee osteoarthritis.
- Author
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Kauppila AM, Kyllonen E, Mikkonen P, Ohtonen P, Laine V, Siira P, Niinimaki J, and Arokoski JP
- Subjects
- Aged, Aged, 80 and over, Body Mass Index, Female, Follow-Up Studies, Humans, Male, Middle Aged, Osteoarthritis, Knee physiopathology, Pain Measurement, Posture, Quality of Life, Range of Motion, Articular, Severity of Illness Index, Sex Factors, Disability Evaluation, Mobility Limitation, Obesity complications, Osteoarthritis, Knee complications, Pain complications
- Abstract
Objective: To examine the attributes of disability in end-stage knee osteoarthritis (OA) by analyzing the relationships between self-reported disability and objectively measured physical function after controlling pain, personal characteristic factors, and pathophysiological factors., Methods: The present study adopted a cross-sectional design. The subjects (n=88, aged 60-80 years) were scheduled for primary unilateral total knee arthroplasty (TKA) due to knee OA. Self-reported disability and pain were measured with the Western Ontario and McMaster Universities OA Index (WOMAC) and the RAND 36-item Health Survey 1.0 (RAND-36). Physical performance tests included a 15-m walk test and stair performance. Knee isometric muscle strength was measured. A clinical examination included analyses of comorbidity, body mass index (BMI), and a detailed knee examination: The flexion range of motion (ROM) was measured; the presence of varus/valgus malalignments and antero-posterior laxity was assessed. Radiographs were analyzed with the Kellgren-Lawrence grading scale., Results: In the linear regression model the WOMAC pain score, antero-posterior laxity of the knee, age, and BMI accounted for 54.8% of the variance in the WOMAC function score. In the bivariate analyses the WOMAC function score had a positive correlation with the 15-m walk (r(s)=0.32, p=0.003), stairs up (r(s)=0.40, p=0.001), and stairs down (r(s)=0.38, p=0.001) tests, and a negative correlation with RPT extension (r(s)=-0.45, p < 0.001) and RPT flexion (r(s)=-0.39, p=0.001) of the affected side and RPT flexion (r(s)=-0.39, p <0.001) of the contralateral side. The results of the physical performance tests also correlated with the RAND-36 Physical function (PF) score. Comorbid diseases and pain deteriorated the results of the physical performance tests and self-reported disability. Female gender deteriorated the results of the physical performance tests and the RAND-36 PF, but not the WOMAC function score. Malalignments, restriction in the flexion ROM of the knee, and the radiologic severity of knee OA did not affect self-reported disability., Conclusion: Pain, BMI, and antero-posterior laxity of the knee joint were major attributes of self-reported disability. The negative effect of comorbid diseases and female gender on health-related quality of life was significant. The results of objectively measured physical performance tests correlated with self-reported disability.
- Published
- 2009
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