Abstract
Background: Knee osteoarthritis, a chronic degenerative disease, is becoming a public health problem around the world due to increasing life expectancy.
Objectives: We aimed to assess the impact of knee osteoarthritis on the quality of life (QoL) of the patients and to identify factors associated with impaired QoL.
Materials and Methods: We conducted a cross-sectional monocentric study including patients with knee osteoarthritis. The pain was evaluated by the Visual Analog Scale (VAS). The short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-PS) was used to assess functional impact. QoL was assessed using the OsteoArthritis of Knee Hip Quality Of Life (OAKHQOL) questionnaire.
Results: Fifty patients were included. The mean age of patients was 59 ± 9 years. The sex ratio was 0.25. At least one comorbidity was noted in 77% of patients. The mean disease duration was 8.82 years. Mean VAS pain and KOOS-PS were 6.8 ± 1.1 and 54.7 ± 9.6/100; respectively. Assessment of the QoL by OAKHQOL showed impaired QoL in all domains; the worst scores concerned the areas of social functioning and pain. Factors associated with an altered QoL were age > 65 years, longer disease duration, higher pain intensity, comorbidities, and functional impairment.
Conclusion: Our patients showed an impaired QoL in all domains, particularly in terms of physical activity and social functioning. Lower QoL scores were associated with age, comorbidities, pain, function, and disease duration. Factors associated with QoL should be considered in the management program of these patients. Screening and the treatment of comorbidities are also useful for the management of knee OA.
Keywords: Quality of life, pain, osteoarthritis, knee, degenerative disease, comorbidities.
Graphical Abstract
[1]
Hunter DJ, Bierma-Zeinstra S. Osteoarthritis Lancet 2019; 393(10182): 1745-59.
[http://dx.doi.org/10.1016/S0140-6736(19)30417-9] [PMID: 31034380]
[http://dx.doi.org/10.1016/S0140-6736(19)30417-9] [PMID: 31034380]
[2]
Puig-Junoy J, Ruiz Zamora A. Socio-economic costs of osteoarthritis: A systematic review of cost-of-illness studies. Semin Arthritis Rheum 2015; 44(5): 531-41.
[http://dx.doi.org/10.1016/j.semarthrit.2014.10.012] [PMID: 25511476]
[http://dx.doi.org/10.1016/j.semarthrit.2014.10.012] [PMID: 25511476]
[3]
Egerton T, Diamond LE, Buchbinder R, Bennell KL, Slade SC. A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians’ barriers and enablers to the management of osteoarthritis. Osteoarthritis Cartilage 2017; 25(5): 625-38.
[http://dx.doi.org/10.1016/j.joca.2016.12.002] [PMID: 27939622]
[http://dx.doi.org/10.1016/j.joca.2016.12.002] [PMID: 27939622]
[4]
Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med 2010; 26(3): 355-69.
[http://dx.doi.org/10.1016/j.cger.2010.03.001] [PMID: 20699159]
[http://dx.doi.org/10.1016/j.cger.2010.03.001] [PMID: 20699159]
[5]
Bunt CW, Jonas CE, Chang JG. Knee pain in adults and adolescents: The initial evaluation. Am Fam Physician 2018; 98(9): 576-85.
[PMID: 30325638]
[PMID: 30325638]
[6]
Vitaloni M, Botto-van Bemden A, Sciortino Contreras RM, et al. Global management of patients with knee osteoarthritis begins with quality of life assessment: A systematic review. BMC Musculoskelet Disord 2019; 20(1): 493.
[http://dx.doi.org/10.1186/s12891-019-2895-3] [PMID: 31656197]
[http://dx.doi.org/10.1186/s12891-019-2895-3] [PMID: 31656197]
[7]
Zhang W, Doherty M, Peat G, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis 2010; 69(3): 483-9.
[http://dx.doi.org/10.1136/ard.2009.113100] [PMID: 19762361]
[http://dx.doi.org/10.1136/ard.2009.113100] [PMID: 19762361]
[8]
Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020; 54(24): 1451-62.
[http://dx.doi.org/10.1136/bjsports-2020-102955] [PMID: 33239350]
[http://dx.doi.org/10.1136/bjsports-2020-102955] [PMID: 33239350]
[9]
Delgado DA, Lambert BS, Boutris N, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. J Am Acad Orthop Surg Glob Res Rev 2018; 2(3): e088.
[http://dx.doi.org/10.5435/JAAOSGlobal-D-17-00088] [PMID: 30211382]
[http://dx.doi.org/10.5435/JAAOSGlobal-D-17-00088] [PMID: 30211382]
[10]
Rat AC, Coste J, Pouchot J, et al. OAKHQOL: A new instrument to measure quality of life in knee and hip osteoarthritis. J Clin Epidemiol 2005; 58(1): 47-55.
[http://dx.doi.org/10.1016/j.jclinepi.2004.04.011] [PMID: 15649670]
[http://dx.doi.org/10.1016/j.jclinepi.2004.04.011] [PMID: 15649670]
[11]
Perruccio AV, Stefan Lohmander L, Canizares M, et al. The development of a short measure of physical function for knee OA KOOS-Physical Function Shortform (KOOS-PS) – an OARSI/OMERACT initiative. Osteoarthritis Cartilage 2008; 16(5): 542-50.
[http://dx.doi.org/10.1016/j.joca.2007.12.014] [PMID: 18294869]
[http://dx.doi.org/10.1016/j.joca.2007.12.014] [PMID: 18294869]
[12]
Ouédraogo DD, Zabsonré JT, Kenagnon ADS, et al. Quality of life of patients with knee osteoarthritis with questionnaire OAKHQOL (OsteoArthritis of Knee Hip Quality of Life) in rheumatology consultation in burkina faso (West Africa). Open J Rheumatol Autoimmune Dis 2014; 4(4): 219-25.
[http://dx.doi.org/10.4236/ojra.2014.44030]
[http://dx.doi.org/10.4236/ojra.2014.44030]
[13]
Gonzalez Sáenz de Tejada M, Escobar A, Herdman M, Herrera C, García L, Sarasqueta C. Adaptation and validation of the Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire for use in patients with osteoarthritis in Spain. Clin Rheumatol 2011; 30(12): 1563-75.
[http://dx.doi.org/10.1007/s10067-011-1855-6] [PMID: 21947701]
[http://dx.doi.org/10.1007/s10067-011-1855-6] [PMID: 21947701]
[14]
Choojaturo S, Sindhu S, Utriyaprasit K, Viwatwongkasem C. Factors associated with access to health services and quality of life in knee osteoarthritis patients: A multilevel cross-sectional study. BMC Health Serv Res 2019; 19(1): 688.
[http://dx.doi.org/10.1186/s12913-019-4441-2] [PMID: 31604433]
[http://dx.doi.org/10.1186/s12913-019-4441-2] [PMID: 31604433]
[15]
Vennu V, Bindawas S. Relationship between falls, knee osteoarthritis, and health-related quality of life: Data from the Osteoarthritis Initiative study. Clin Interv Aging 2014; 9: 793-800.
[http://dx.doi.org/10.2147/CIA.S62207] [PMID: 24855348]
[http://dx.doi.org/10.2147/CIA.S62207] [PMID: 24855348]
[16]
Yan H, Guo J, Zhou W, Dong C, Liu J. Health-related quality of life in osteoarthritis patients: A systematic review and meta-analysis. Psychol Health Med 2021; 1-16.
[PMID: 34465255]
[PMID: 34465255]
[17]
Carr AJ. Beyond disability: Measuring the social and personal consequences of osteoarthritis. Osteoarthritis Cartilage 1999; 7(2): 230-8.
[http://dx.doi.org/10.1053/joca.1998.0154] [PMID: 10222222]
[http://dx.doi.org/10.1053/joca.1998.0154] [PMID: 10222222]
[18]
Hiligsmann M, Cooper C, Guillemin F, et al. A reference case for economic evaluations in osteoarthritis: An expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum 2014; 44(3): 271-82.
[http://dx.doi.org/10.1016/j.semarthrit.2014.06.005] [PMID: 25086470]
[http://dx.doi.org/10.1016/j.semarthrit.2014.06.005] [PMID: 25086470]
[19]
Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian J Intern Med 2011; 2(2): 205-12.
[PMID: 24024017]
[PMID: 24024017]
[20]
Fekete H, Guillemin F, Pallagi E, Fekete R, Lippai Z, Luterán F. Evaluation of osteoarthritis knee and hip quality of life (OAKHQoL): Adaptation and validation of the questionnaire in the Hungarian population. Ther Adv Musculoskelet Dis 2020; 12: 1759720X20959570.
[21]
Nikolic G, Nedeljkovic B, Trajkovic G, et al. Pain, physical function, radiographic features, and quality of life in knee osteoarthritis agricultural workers living in rural population. Pain Res Manag 2019; 2019: 1-5.
[http://dx.doi.org/10.1155/2019/7684762] [PMID: 31662813]
[http://dx.doi.org/10.1155/2019/7684762] [PMID: 31662813]
[22]
Goetz C, Ecosse E, Rat AC, Pouchot J, Coste J, Guillemin F. Measurement properties of the osteoarthritis of knee and hip quality of life OAKHQOL questionnaire: An item response theory analysis. Rheumatology 2011; 50(3): 500-5.
[http://dx.doi.org/10.1093/rheumatology/keq357] [PMID: 21071480]
[http://dx.doi.org/10.1093/rheumatology/keq357] [PMID: 21071480]
[23]
Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res 1993; 2(2): 153-9.
[http://dx.doi.org/10.1007/BF00435734] [PMID: 8518769]
[http://dx.doi.org/10.1007/BF00435734] [PMID: 8518769]
[24]
Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med 1993; 118(8): 622-9.
[http://dx.doi.org/10.7326/0003-4819-118-8-199304150-00009] [PMID: 8452328]
[http://dx.doi.org/10.7326/0003-4819-118-8-199304150-00009] [PMID: 8452328]
[25]
Singh A, Campbell JA, Venn A, et al. Association between knee symptoms, change in knee symptoms over 6-9 years, and SF-6D health state utility among middle-aged Australians. Qual Life Res 2021; 30(9): 2601-13.
[http://dx.doi.org/10.1007/s11136-021-02859-5] [PMID: 33942204]
[http://dx.doi.org/10.1007/s11136-021-02859-5] [PMID: 33942204]
[26]
Shalhoub M, Anaya M, Deek S, et al. The impact of pain on quality of life in patients with osteoarthritis: A cross-sectional study from Palestine. BMC Musculoskelet Disord 2022; 23(1): 248.
[http://dx.doi.org/10.1186/s12891-022-05207-x] [PMID: 35287651]
[http://dx.doi.org/10.1186/s12891-022-05207-x] [PMID: 35287651]
[27]
Mohd Yusuf SY, Md-Yasin M, Mohd Miswan MF. Does less pain predict better quality of life among Malaysian patients with mild–moderate knee osteoarthritis? Clin Pract 2022; 12(2): 219-30.
[http://dx.doi.org/10.3390/clinpract12020026] [PMID: 35447854]
[http://dx.doi.org/10.3390/clinpract12020026] [PMID: 35447854]
[28]
Braaksma C, Wolterbeek N, Veen MR, Prinsen CAC, Ostelo RWJG. Systematic review and meta-analysis of measurement properties of the Hip disability and Osteoarthritis Outcome Score - Physical Function Shortform (HOOS-PS) and the Knee Injury and Osteoarthritis Outcome Score - Physical Function Shortform (KOOS-PS). Osteoarthritis Cartilage 2020; 28(12): 1525-38.
[http://dx.doi.org/10.1016/j.joca.2020.08.004] [PMID: 32827668]
[http://dx.doi.org/10.1016/j.joca.2020.08.004] [PMID: 32827668]
[29]
Previtali D, Capone G, Marchettini P, Candrian C, Zaffagnini S, Filardo G. High prevalence of pain sensitization in knee osteoarthritis: A meta-analysis with meta-regression. Cartilage 2022; 13(1)
[http://dx.doi.org/10.1177/19476035221087698] [PMID: 35356833]
[http://dx.doi.org/10.1177/19476035221087698] [PMID: 35356833]
[30]
Montero A, Mulero JF, Tornero C, Guitart J, Serrano M. Pain, disability and health-related quality of life in osteoarthritis-joint matters: An observational, multi-specialty trans-national follow-up study. Clin Rheumatol 2016; 35(9): 2293-305.
[http://dx.doi.org/10.1007/s10067-016-3248-3] [PMID: 27068737]
[http://dx.doi.org/10.1007/s10067-016-3248-3] [PMID: 27068737]
[31]
Wang K, Kim HA, Felson DT, et al. Radiographic knee osteoarthritis and knee pain: Cross-sectional study from five different racial/ethnic populations. Sci Rep 2018; 8(1): 1364.
[http://dx.doi.org/10.1038/s41598-018-19470-3] [PMID: 29358690]
[http://dx.doi.org/10.1038/s41598-018-19470-3] [PMID: 29358690]
[32]
Trevisol DJ, Moreira LB, Kerkhoff A, Fuchs SC, Fuchs FD. Health-related quality of life and hypertension: A systematic review and meta-analysis of observational studies. J Hypertens 2011; 29(2): 179-88.
[http://dx.doi.org/10.1097/HJH.0b013e328340d76f] [PMID: 21045726]
[http://dx.doi.org/10.1097/HJH.0b013e328340d76f] [PMID: 21045726]
[33]
Snarska K, Chorąży M, Szczepański M, Wojewódzka-Żelezniakowicz M, Ładny JR. Quality of life of patients with arterial hypertension. Medicina 2020; 56(9): 459.
[http://dx.doi.org/10.3390/medicina56090459] [PMID: 32916933]
[http://dx.doi.org/10.3390/medicina56090459] [PMID: 32916933]
[34]
Mokhtari Z, Gheshlagh RG, Kurdi A. Health-related quality of life in Iranian patients with type 2 diabetes: An updated meta-analysis. Diabetes Metab Syndr 2019; 13(1): 402-7.
[http://dx.doi.org/10.1016/j.dsx.2018.10.007] [PMID: 30641733]
[http://dx.doi.org/10.1016/j.dsx.2018.10.007] [PMID: 30641733]
[35]
Omorou AY, Achit H, Wieczorek M, et al. Impact of comorbidities and functional impairment on 5-year loss of health utility in patients with lower-limb osteoarthritis in the KHOALA cohort. Qual Life Res 2019; 28(11): 3047-54.
[http://dx.doi.org/10.1007/s11136-019-02243-4] [PMID: 31273625]
[http://dx.doi.org/10.1007/s11136-019-02243-4] [PMID: 31273625]
[36]
Ben Tekaya A, Hamdi O, Rouached L, et al. Clinical comorbidity phenotype in knee osteoarthritis is associated with higher intensity scores. Acta Med Iran 2022; 60(2): 120-8.
[37]
Jeong JN, Kim SH, Park KN. Relationship between objectively measured lifestyle factors and health factors in patients with knee osteoarthritis. Medicine 2019; 98(26): e16060.
[http://dx.doi.org/10.1097/MD.0000000000016060] [PMID: 31261513]
[http://dx.doi.org/10.1097/MD.0000000000016060] [PMID: 31261513]
[38]
Adiguzel L, Kilic D. An investigation of the relationship between the functional status of the individuals with knee osteoarthritis and their quality of life. Niger J Clin Pract 2022; 25(5): 576-81.
[http://dx.doi.org/10.4103/njcp.njcp_1370_21] [PMID: 35593598]
[http://dx.doi.org/10.4103/njcp.njcp_1370_21] [PMID: 35593598]
[39]
Kangeswari P, Arulappan J. Effectiveness of nurse-led intervention on quality of life of patients with knee osteoarthritis. J Patient Exp 2022; 9.
[http://dx.doi.org/10.1177/23743735221098254] [PMID: 35520013]
[http://dx.doi.org/10.1177/23743735221098254] [PMID: 35520013]
[40]
Santana ÉTN, da Cunha MS, Brandão LVN, et al. Comparison between exercise therapy and non-hydrolyzed collagen (UC-II) in functionality and quality of life in women with knee osteoarthritis. Wien Klin Wochenschr 2022.
[http://dx.doi.org/10.1007/s00508-022-02037-8] [PMID: 35612617]
[http://dx.doi.org/10.1007/s00508-022-02037-8] [PMID: 35612617]
[41]
Bartholdy C, Christensen R, Kristensen LE, et al. Association between weight loss and spontaneous changes in physical inactivity in overweight/obese individuals with knee osteoarthritis: An eight‐week prospective cohort study. Arthritis Care Res 2020; 72(3): 397-404.
[http://dx.doi.org/10.1002/acr.23868] [PMID: 30821925]
[http://dx.doi.org/10.1002/acr.23868] [PMID: 30821925]
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