Prevalence of multimorbid degenerative lumbar spinal stenosis with knee and/or hip osteoarthritis: protocol for a systematic review and meta-analysis

Abstract

Background Lumbar spinal stenosis (LSS) and knee and hip osteoarthritis (OA) are prevalent conditions in the aging population and published literature suggests they share many symptoms and often are present at the same time in patients. However, no prevalence estimates of multimorbid LSS and knee and/or hip OA are currently available. The primary objective of this systematic review is therefore to estimate the prevalence of multimorbid LSS with knee and/or hip OA using radiological, clinical, and combined case definitions. Methods This systematic review protocol has been designed according to the guidelines from the Cochrane Collaboration and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. A comprehensive search will be performed in the following databases: MEDLINE, EMBASE, CENTRAL, and CINAHL. Forward citation tracking will be performed in Web of Science. No restriction for publication date and language will be applied in the literature search, but only articles in English will be included. The search strategy will include the following domains: LSS, knee OA, and hip OA. Retrieved citations will be screened by two authors independently. Disagreements will be discussed until consensus, and a third reviewer will be consulted if consensus cannot be reached. Data extraction and assessment of risk of bias assessment will be done by two authors independently, using a standardized data extraction form and a modified risk of bias tool for prevalence studies. Meta-analysis estimating prevalence with 95% CI will be performed using a random effects model. Meta-regression analyses will be performed to investigate the impact of the following covariates: LSS clinical presentations, sample population, healthcare setting, risk of bias, and other patient characteristics on prevalence estimates for multimorbid LSS and knee and/or hip OA. Discussion The results of this review will provide the first estimates of the prevalence of multimorbid LSS and hip and knee OA based on various case definitions. The impact of covariates such as LSS clinical presentations, sample population, healthcare setting, risk of bias, and patient characteristics on prevalence estimates will also be presented. Systematic review registration PROSPERO, awaiting registration

Impact of Preoperative Total Knee Arthroplasty on Radiological and Clinical Outcomes of Spinal Fusion for Concurrent Knee Osteoarthritis and Degenerative Lumbar Spinal Diseases

“…Degenerative diseases including osteoarthritis and spinal stenosis are serious public health concerns globally because of the severe pain and disability they cause [ 14 ]. Specifically, lower back pain and osteoarthritis were the first ranked and 12th ranked, respectively, global burden of diseases that cause disability from a systemic analysis in 2016 [ 15 ].…”

“…Specifically, lower back pain and osteoarthritis were the first ranked and 12th ranked, respectively, global burden of diseases that cause disability from a systemic analysis in 2016 [ 15 ]. Moreover, these chronic conditions lead to multi-morbidity, which limit function and cause pain and disability [ 14 , 15 ]. However, the impact of multi-morbid conditions has not been extensively studied yet [ 14 ].…”

“…Moreover, these chronic conditions lead to multi-morbidity, which limit function and cause pain and disability [ 14 , 15 ]. However, the impact of multi-morbid conditions has not been extensively studied yet [ 14 ]. In an arthroplasty study, the impact of total hip arthroplasty in spinal fusion was reported in hip-spine syndrome, but there is a relative lack of evidence for that of TKA [ 4 ].…”

Prevalence of multimorbid degenerative lumbar spinal stenosis with knee or hip osteoarthritis: a systematic review and meta-analysis

“…The protocol for this review has been published [ 28 ] and registered in PROSPERO (CRD42020177759). This review was conducted according to the guidelines from the Cochrane Collaboration [ 29 ] and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement [ 30 ] (Additional file 1 ).…”

“…Two reviewers (JJY and RKJ) independently assessed the risk of bias in all included studies using a modified version of the Risk of Bias Tool for Prevalence Studies [ 36 ]. Modifications made to the tool for the purposes of this study have been described in detail in the review protocol [ 28 ] (Additional file 3 ). In summary, we removed item 5 from the original tool as we assumed both clinical and imaging information can only be collected directly from participants.…”