Comorbidities in Patients With End-Stage Knee OA: Prevalence and Effect on Physical Function

Publication date: November 2019

Source: Archives of Physical Medicine and Rehabilitation, Volume 100, Issue 11

Author(s): Won Bin Kim, Bo Ryun Kim, Sang Rim Kim, Eun Young Han, Kwang Woo Nam, So Young Lee, Suh Min Ji, Jong Hyun Kim

Abstract

Objective

To investigate the prevalence of comorbidities and their effect on physical function, quality of life (QOL), and pain, in patients with end-stage knee osteoarthritis (OA).

Design

A cross-sectional study.

Setting

A rehabilitation facility at university hospital.

Participants

Patients (N=577; 503 women and 74 men) diagnosed with end-stage knee OA between October 2013 and June 2018.

Intervention

Not applicable.

Main Outcome Measures

Comorbidities were as follows: osteoporosis, presarcopenia, degenerative spine disease, diabetes, and hypertension. All patients completed the following performance-based physical function tests: stair-climbing test (SCT), 6-minute walk test (6MWT), timed Up and Go (TUG) test, and gait analysis. Self-reported physical function and pain were measured using Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and a visual analog scale (VAS), respectively, and self-reported QOL was measured using EuroQoL 5 dimensions (EQ-5D) questionnaire.

Results

Univariate analyses revealed that patients with osteoporosis had significantly higher scores in SCT ascent, SCT descent, TUG, WOMAC pain tests, and lower scores in 6MWT, gait speed, and cadence tests than those without osteoporosis. Patients with presarcopenia recorded higher scores in SCT ascent, TUG, EQ-5D, and lower scores in 6MWT and gait speed tests than those without presarcopenia. Patients with degenerative spine disease showed higher scores in WOMAC pain and lower scores in gait speeds than those without degenerative spine disease. Patients with diabetes showed higher scores in SCT ascent than those without diabetes, and patients with hypertension showed lower scores in 6MWT than those without hypertension. After adjusting age, sex, and body mass index, SCT descent retained significant association with osteoporosis, SCT ascent showed independent association with presarcopenia and diabetes, and WOMAC pain revealed significant association with degenerative spine disease.

Conclusion

The results confirm associations between comorbidities, performance-based and self-reported physical functions, and QOL in patients with end-stage knee OA.

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