Relationship between radiological severity and clinical and psychological factors in knee osteoarthritis

Abstract

This study was designed to investigate the relationship between radiological severity and clinical and psychological factors in patients with knee osteoarthritis (OA). Patients with knee OA (n = 100) were included in the study. Radiographic staging was done using Kellgren-Lawrence (KL) radiological rating scale. Stage 1-2 changes according to KL were grouped as 'early' and stage 3-4 as 'late' radiological OA. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used for self-reported disability. Performance-based functional assessments were measured as time needed to walk 15 m and time needed to climb ten steps. Health-related quality of life was assessed by Nottingham Health Profile (NHP). Beck Depression Inventory (BDI) was used to assess the presence and severity of depression. Social isolation was assessed by a related NHP subscale. Significantly higher scores were found in the late stage group for NHP pain, physical mobility and social isolation subscales and all WOMAC subscales. Mean BDI score was significantly higher (p = 0.001) and performance-based functional score was significantly worse (p < 0.001) in the late stage group compared to the early stage. In logistic regression analysis, NHP social isolation subscore was found to be associated with WOMAC pain subscore (p = 0.013, odds ratio [OR] = 1.163; 95% confidence interval [CI], 1.032-1.309) and radiological severity (p = 0.018, OR = 2.924; 95% CI, 1.198-7.136). Radiological severity is an important indicative factor for pain, disability, depression and social isolation. We believe that assessment of psychological involvement in addition to pain and disability might provide benefit in the management of patients with advanced radiological knee OA.

Correlations between ultrasonographic findings, clinical scores, and depression in patients with knee osteoarthritis

“…In this study, we found that the frequency of depression among OA patients was 30%, with a highly statistically significant difference regarding BDI score between OA patients and healthy controls (p=0.005). This is similar to that reported by Ozcakir et al (18) who found that 27% of their patients had moderate to mild depression. This also agreed with Kim et al (19) who reported that 26.9% of patients with symptomatic knee OA had depressive symptoms.…”

Are Psychological Factors Associated with Pain Worsening in Individuals with Knee Osteoarthritis? A Systematic Review

“…One of the psychological factors assessed by studies in our review was depression. Of eleven studies [14][15][16][17][18][19][20][21][22][23][24], six at least showed a significant relationship between depression and pain, but these findings corresponded to evidence level IV because they were confirmed by cross-sectional studies; the results of the two cohort studies were not consistent. Pain catastrophizing had been measured by ten studies [14,15,19,20,23,[25][26][27][28][29] in our review and was shown to be related with pain worsening in six cross-sectional studies as evidence level IV and in one prospective cohort study as evidence level II.…”

Is Radiographic Severity of Knee Osteoarthritis Important for Detecting Differences in Physical Performance and Isokinetic Strength?

“…Radyolojik OA şiddeti arttıkça fiziksel fonksiyonun azaldığı vurgulanmaktadır (11)(12)(13). Dizin fiziksel fonksiyonu beden ağırlı-ğı (14), hareket açıklığı (15), kas aktivasyonu ve propriosepsiyon (4) gibi nöromuskuloskeletal faktörlerle belirlenir.…”

“…Şiddetli ve hafif derecede OA olan kadın ve erkeklerin fiziksel fonksiyon ve kuvvetini karşılaştıran az sayıda çalışma vardır (11,12). Bu çalışmalarda fiziksel fonksiyon, denge, otur kalk süresi, 4 metre (11) ve 15 metre yürüme süresi, basamak çık-ma (12) gibi zaman temelli performans testleri, Western Ontario and McMaster Universities Osteoarthritis İndeks (WOMAC) (10,11) ile ve kuvvet 60 0 /s hızda izokinetik testle (12) belirlenmiştir.…”