Perception and presentation of function in patients with unilateral versus bilateral knee osteoarthritis

Abstract

Objective Lower extremity functional performance and perception of functional abilities influence clinical management in people diagnosed with unilateral or bilateral knee osteoarthritis. The purpose of this study was to determine if there were differences in perception of function and performance during functional tasks between individuals with unilateral and bilateral knee osteoarthritis. Methods The functional abilities of patients with symptomatic and radiographic diagnosed unilateral (N=84) or bilateral (N=68) knee osteoarthritis were evaluated with self-reports and performance-based tests. Self reports included the Knee Outcome Survey (KOS), Global Rating Scale (GRS), and Physical Component of Short Form-36 (PCS); functional tests included Timed Up-and-Go (TUG), Stair Climbing Test (SCT), and 6-minute Walk (6MW). Separate MANOVAs were performed separately for men and women to determine if perception (self-reports) and performance (functional tests) were dependent on the number of involved knees. Results No significant main effects were observed in functional performance between groups for either sex. Similarly, the perception measures did not differ between groups. In general, individuals diagnosed with unilateral and bilateral knee osteoarthritis both performed functional tasks and perceived their functional ability similarly. Conclusion. Regardless of the number of involved knees, individuals with knee osteoarthritis perform and perceive their functional ability similarly, which suggests that clinicians need to consider other factors, such as include how long the disease has been progressing or how functional abilities have changed when treating patients with knee osteoarthritis.

Contralateral Knee Effect on Self‐Reported Knee‐Specific Function and Global Functional Assessment: Data From the Osteoarthritis Initiative

“…However, objective physical performance tests were capable of detecting unilateral differences in knee pain, with the repeated chair stand test revealing the highest sensitivity compared to short‐ or long‐distance walking tests. Our findings differ from those of Marmon et al who reported that persons with knee OA perform and perceive their functional ability similarly, regardless of the number of knees involved. Our results in discordant cases versus controls with bilaterally painful knees are in line with a recent study by Riddle and Stratford who found a stronger contrast between OAI subjects with severe unilateral compared to bilateral pain for the repeated chair stand than for walking tests.…”

Unilateral vs bilateral symptomatic knee osteoarthritis: associations between pain intensity and function

“…Our study is consistent with previously published evidence [5,10,11] but contradicts a recent paper published by Marmon et al [9]. We suspect that because our study had a substantially larger sample than that of the Marmon et al [9] study (n = 853 in our study vs n = 152) and because we stratified by pain severity levels of both limbs, we found potentially meaningful differences in persons with unilateral vs bilateral pain.…”

“…This greater pain load could theoretically compound functional deficits, particularly for activities like walking that require bilateral knee movements. Research to date on this issue, however, has come to divergent conclusions, with some suggesting that the presence of unilateral vs bilateral knee pain has no association with functional status [9], while others have found that persons with bilateral knee pain display greater functional loss or greater worsening than persons with unilateral knee pain [5,10,11]. None of this prior evidence accounted for pain severity of both limbs, which we suspect may help to explain the divergent findings.…”

Associations between biomarkers of bone and cartilage turnover, gender, pain categories and radiographic severity in knee osteoarthritis

“…The data suggest that unilateral radiographic knee OA is rare in a population of symptomatic knee OA, as only one patient with a KL score of 3 or above in one knee had a KL score of 0 in the contralateral knee, and very few ( n = 19, 1.6%) had a KL score of 1 in the presence of KL 3 or above in the contralateral knee. Data available in the literature on the natural presence of unilateral OA indicates a much larger proportion of patients with unilateral OA than found in the current report [18, 19], yet the definition of unilateral OA in published reports varies. Presence of unilateral OA has been shown to influence patient-reported physical function impairment more than bilateral OA [18], and it has been speculated that the presence of bilateral OA may hamper joint-specific pain reporting, perhaps most importantly in clinical trials with localised treatment (topical or intra-articular).…”