Dataset Information

Impact of end-stage knee osteoarthritis on perceived physical function and quality of life: A descriptive study from Jordan.

ABSTRACT:

Objective

Of the present study was to evaluate the impact of end-stage knee OA on patient's perception of their functional abilities and quality of life (QoL) using the self-reported questionnaire; the Knee Injury and Osteoarthritis Outcome Score (KOOS), and to determine the contribution of knee pain on patient's perceived outcomes.

Methods

Patients with end-stage knee OA who are on the waiting list for total knee arthroplasty were recruited in this cross-sectional study. Patients were asked to fill out the KOOS questionnaire. Knee pain for both sides was quantified on a continuous scale from 0-10. Age, and anthropometric data were recorded. Descriptive statistics were calculated for patients' characteristics, and for the scores of each KOOS subscale. Hierarchical linear regression models were created to determine the contributions of knee pain on two KOOS subscales; the function in daily living (KOOS-ADL), and the knee-related quality of life (KOOS-QoL).

Results

Patients in this study scored low across KOOS subscales (27.7% - 54.2%) with the QoL subscale being the lowest. After accounting for age and BMI, hierarchical linear regressions revealed that knee pain in both sides were determinants of self-perceived KOOS-ADLs, while only knee pain in the most-affected side significantly contributed to lower KOOS-QOL scores.

Conclusion

End-stage knee OA negatively impact the patients' perceived function and quality of life. Patients' KOOS scores were similar to those reported in other countries, with QoL being the domain most affected. Our findings demonstrate that the level of knee pain has a determinant effect on our patients' perceptions of functional abilities and QoL. As waiting-list patients, addressing knee pain with a targeted regimen prior to TKA, as well as increasing patient's awareness about knee pain management, may improve/ or minimize deterioration in perceived functional ability and QoL while awaiting TKA.

SUBMITTER: Abujaber S

PROVIDER: S-EPMC10256207 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Impact of end-stage knee osteoarthritis on perceived physical function and quality of life: A descriptive study from Jordan.

Abujaber Sumayeh S Altubasi Ibrahim I Hamdan Mohammad M Al-Zaben Raed R

PloS one 20230609 6

<h4>Objective</h4>Of the present study was to evaluate the impact of end-stage knee OA on patient's perception of their functional abilities and quality of life (QoL) using the self-reported questionnaire; the Knee Injury and Osteoarthritis Outcome Score (KOOS), and to determine the contribution of knee pain on patient's perceived outcomes.<h4>Methods</h4>Patients with end-stage knee OA who are on the waiting list for total knee arthroplasty were recruited in this cross-sectional study. Patients ...[more]

PMID: 37294813

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Project description:ObjectiveWe aimed to describe the natural history leading to end-stage knee osteoarthritis (esKOA), focusing on knee symptoms, radiographic severity, and the presence of limited mobility or instability.MethodsWe performed knee-based analyses of Osteoarthritis Initiative data from 7691 knees (4165 participants). We used a validated definition of esKOA that relied on meeting one of two criteria: (1) severe radiographic knee osteoarthritis (Kellgren-Lawrence [KL] grade=4) with moderate-to-intense pain (Likert WOMAC pain+function>11/88) or (2) KL grade<4 with intense or severe pain (WOMAC pain+function>22) and limited mobility (flexion contracture≥5°) or instability (based on a varus and valgus stress test). We also introduced an alternate definition of esKOA that relied on meeting one of two criteria that omitted physical exam findings:(1) severe radiographic knee osteoarthritis (KL grade=4) with at least moderate symptoms or (2) KL grade=2 or 3 with intense or severe symptoms and persistent knee pain (frequent knee pain during three or more months in the past year). We used descriptive statistics to explore the frequency of components of esKOA at the index visit when they had incident esKOA, at the annual visit before developing esKOA, and the interval change between those visits.ResultsOur analytic sample was mostly female (58%), without radiographic knee osteoarthritis (KL grade=0 or 1; 60%), without stability or mobility concerns (91%), and without persistent knee pain (77%). At the visit before incident esKOA, most knees already had moderate-to-severe radiographic osteoarthritis using the original (62%) or alternate (50%) definition (versus <15% for either definition of no esKOA). Over 80% of knees that reached the criteria for esKOA achieved this based on increased knee symptom severity - typically without worsening radiographic severity (80%).ConclusionRadiographic severity predisposed a knee to esKOA. However, worsening knee symptoms led to the development of incident esKOA. If investigators want to increase the chance of identifying incident esKOA as an outcome, they should enrich their study samples with people with moderate-to-severe radiographic osteoarthritis. Our findings also highlight the potential reversibility of esKOA (a knee that is classified with esKOA but later is not classified with esKOA). Reversibility is not a flaw of an outcome defining esKOA but rather a desirable clinical outcome to demonstrate a therapeutic intervention can help people with esKOA improve their knee symptoms and delay a knee replacement.

Project description:BackgroundEnd-stage knee osteoarthritis (OA) patients awaiting total knee replacement (TKR) often experience prolonged wait times and worsening symptoms. Whole-body vibration (WBV) has shown potential benefits in OA management. This study compared the efficacy of supervised exercise therapy alone and combined with WBV in reducing pain and improving function in this population.MethodsIn this prospective cohort study, 555 patients with end-stage knee OA awaiting TKR were allocated to three groups: Exercise (n = 227), Exercise + WBV (n = 127), and Control (n = 201). The Exercise and Exercise + WBV groups underwent an 8-week intervention comprising strength and flexibility exercises. Primary outcomes were pain (Numeric Pain Rating Scale, NPRS) and function (Knee Injury and Osteoarthritis Outcome Score, KOOS). Outcomes were assessed at baseline and after the final treatment session. Statistical analysis included ANOVA with post-hoc Bonferroni correction for baseline comparisons and paired t-tests for longitudinal comparisons. Minimal Clinically Important Difference (MCID) and Minimal Detectable Change (MDC) were calculated to assess the clinical significance of the results.ResultsBoth exercise modalities significantly reduced knee pain from baseline to final session (P < 0.001). The Exercise + WBV group showed a larger reduction in NPRS score (mean ± standard deviation (SD); from 5.57 ± 1.82 to 4.65 ± 2.15) compared to the Exercise group (from 5.35 ± 2.11 to 4.88 ± 1.96), exceeding both MCID (0.94 vs. 0.45) and MDC (0.34 vs. 0.27) thresholds. The Exercise + WBV group demonstrated significant improvements in KOOS subscales (KOOS-KP: 54.31 ± 16.95 to 60.04 ± 17.13, P < 0.001; KOOS-S: 57.27 ± 19.56 to 60.50 ± 18.07, P = 0.033; KOOS-ADL: 66.99 ± 19.42 to 71.52 ± 16.32, P = 0.003), while the Exercise group did not. These improvements in KOOS subscales met or exceeded the MDC (ranging from 2.42 to 3.99) but showed variable clinical significance relative to MCID (- 0.49 to 0.04). The Exercise + WBV group also showed significant improvement in knee ROM (110.68° ± 16.52° to 115.43° ± 18.59°, P < 0.001), while the Exercise group did not.ConclusionBoth interventions effectively reduced pain and improved function in end-stage knee OA patients awaiting TKR, with the addition of WBV leading to greater improvements in several outcomes. Particularly in pain reduction, changes exceeded both MCID and MDC thresholds, suggesting WBV's potential as a clinically valuable adjunct to exercise therapy. While some improvements in functional outcomes were statistically significant and surpassed MDC values, their clinical significance varied, future research should focus on optimizing WBV protocols and investigating long-term effects to guide clinical practice in managing patients awaiting TKR.

Project description:BackgroundSarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a one-year post-operative period.MethodsThis prospective cohort study was conducted between 2015 to 2018 at our hospital. Patients with end-stage OA of the knee waiting for TKA were recruited into the study. Primary outcome measures were change in muscle strength, mass and function. Secondary outcome measures were quality of life (QOL) measurements for pain, psychological and physical health.ResultsFifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects was comparable (67.89 ± 7.07 vs. 67.92 ± 6.85; p = 0.99), but sarcopenic subjects had a lower body mass index (BMI) (25.64 ± 2.64 vs. 28.57 ± 4.04; p = 0.01). There was a statistically significant improvement in walking speed (10.24 ± 5.35 vs. 7.69 ± 2.68, p < 0.01) and muscle strength in both sarcopenic and non-sarcopenic patients after TKA. This was accompanied by an improvement trend in muscle mass in all subjects. There was no change in handgrip power before and after TKA and subsequent follow-up (19.31 ± 5.92 vs. 18.98 ± 6.37 vs. 19.36 ± 7.66; p = 0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27 ± 15.98 vs. 20.65 ± 15.24 vs. 16.65 ± 18.13) and SF12v2 (PCS: 33.06 ± 8.55 vs. 38.96 ± 8.01 vs. 40.67 ± 7.93) revealed progressive significant improvement (both comparisons p ≤ 0.01). Further analysis with the IPAQ also found increased engagement of high-intensity activities.ConclusionsThis study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon, but both sarcopenic and non-sarcopenic OA patients achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects.Trial registrationRegistry: ClinicalTrials.gov , Registration number: NCT03579329 . Date of registration: 6 July 2018. Retrospectively registered.

Dataset Information

Impact of end-stage knee osteoarthritis on perceived physical function and quality of life: A descriptive study from Jordan.

Objective

Methods

Results

Conclusion

Publications

Impact of end-stage knee osteoarthritis on perceived physical function and quality of life: A descriptive study from Jordan.

Similar Datasets

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