Assessment of Knee Osteoarthritis Severity using New Multifactorial Scale (KHIUS) in Northwest Syria
DOI:
https://doi.org/10.53560/PPASB(61-2)919Keywords:
Knee Osteoarthritis, KHIUS, Risk Factors, ESR, Biomarker, WOMACAbstract
The present study aimed to identify the risk factors associated with knee osteoarthritis (OA) in Northwest Syria and to evaluate the reliability of our newly proposed Khatib-Khaled Idlib University Scale (KHIUS) in assessing knee OA severity. The study enrolled 101 patients with knee OA, diagnosed through X-ray at the orthopedic clinic. The Kellgren and Lawrence classification was employed to determine the X-ray knee OA grades. The erythrocyte sedimentation rate (ESR) value was obtained as a biomarker after excluding rheumatoid arthritis, other inflammatory diseases, and malignant tumors. The risk factors of knee OA assessed in our study included age, gender, BMI, and physical activity. Each patient completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and KHIUS to evaluate knee OA severity. Correlation coefficients of two scales, i.e., WOMAC and X-ray knee OA grading as well as KHIUS and X-ray knee OA grading, were determined. The mean age of the patients was 52.84 ± 9.74 years (age range 25-80 years). Most patients had low daily activity levels, and the left knee was the most affected. In our study, the correlation coefficient between WOMAC and KHIUS was strong (R: 80.3%, P < 0.01). The correlation coefficient between X-ray KL knee OA grades and WOMAC was moderate (R: 50.9%, P < 0.01), whereas the correlation coefficient between X-ray KL knee OA grades and KHIUS was comparatively stronger (R: 75.7%, P < 0.01). KHIUS can be a reliable scale to assess knee OA severity and to guide the method of treatment by orthopedic surgeons. In addition, KHIUS is more closely related to X-ray KL knee OA grading than other clinical scales.
References
M. Sowers. Epidemiology of risk factors for osteoarthritis: systemic factors. Current Opinion in Rheumatology 13: 447–451 (2001).
M. Fransen, L. Bridgett, L. March, D. Hoy, E. Penserga, and P. Brooks. The epidemiology of osteoarthritis in Asia. International Journal of Rheumatic Diseases 14(2): 113–121 (2011).
T. Neogi, and Y. Zhang. Epidemiology of Osteoarthritis. Rheumatic Disease Clinics of North America 39(1): 1–19 (2013).
S. Lee, and S.-J. Kim. Prevalence of knee osteoarthritis, risk factors, and quality of life: The Fifth Korean National Health And Nutrition Examination Survey. International Journal of Rheumatic Diseases 20(7): 809–817 (2017).
S. Muraki, H. Oka, T. Akune, A. Mabuchi, Y. En-yo, M. Yoshida, A. Saika, T. Suzuki, H. Yoshida, H. Ishibashi, S. Yamamoto, K. Nakamura, H. Kawaguchi, and N. Yoshimura. Prevalence of radiographic knee osteoarthritis and its association with knee pain in the elderly of Japanese population-based cohorts: The ROAD study. Osteoarthritis and Cartilage 17(9): 1137–1143 (2009).
J. Bedson, and P.R. Croft. The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature. BMC Musculoskeletal Disorders 9: 116 (2008).
N. Verzijl, R.A. Bank, J.M. TeKoppele, and J. DeGroot. AGEing and osteoarthritis: A different perspective. Current Opinion in Rheumatology 15(5): 616–622 (2003).
A.S. Anderson, and R.F. Loeser. Why is osteoarthritis an age-related disease? Best Practice & Research Clinical Rheumatology 24(1): 15–26 (2010).
J.A. Gokhale, S.R. Frenkel, and P.E. Dicesare. Estrogen and osteoarthritis. American Journal of Orthopedics (Belle Mead, N.J.) 33(2): 71–80 (2004).
J. Sellam, and F. Berenbaum. Is osteoarthritis a metabolic disease? Joint Bone Spine 80(6): 568–573 (2013).
N. Zapata-Linares, F. Eymard, F. Berenbaum, and X. Houard. Role of adipose tissues in osteoarthritis. Current Opinion in Rheumatology 33(1): 84–93 (2021).
T.D. Spector, P.A. Harris, D.J. Hart, F.M. Cicuttini, D. Nandra, J. Etherington, R.L. Wolman, and D.V. Doyle. Risk of osteoarthritis associated with long-term weight-bearing sports: A radiologic survey of the hips and knees in female ex-athletes and population controls. Arthritis & Rheumatism 39(9): 988–995 (1996).
E. Shorter, A. J. Sannicandro, B. Poulet, and K. Goljanek-Whysall. Skeletal Muscle Wasting and Its Relationship With Osteoarthritis: a Mini-Review of Mechanisms and Current Interventions. Current Rheumatology Reports 21(8): 40 (2019).
B. Yucesoy, L.E. Charles, B. Baker, and C.M. Burchfiel. Occupational and genetic risk factors for osteoarthritis: A review. Work 50(2): 261–273 (2015).
E.M. Roos, and L.S. Lohmander. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint Injury to Osteoarthritis. Health and Quality of Life Outcomes 1: 64 (2003).
E.M. Roos, H.P. Roos, L.S. Lohmander, C. Ekdahl, and B.D. Beynnon. Knee Injury and Osteoarthritis Outcome Score (KOOS)—Development of a Self-Administered Outcome Measure. Journal of Orthopaedic & Sports Physical Therapy 28(2): 88–96 (1998).
D.W. Murray, R. Fitzpatrick, K. Rogers, H. Pandit, D.J. Beard, A.J. Carr, and J. Dawson. The use of the Oxford hip and knee scores. The Journal of Bone and Joint Surgery - British Volume 89(8): 1010–1014 (2007).
N.J. Collins, D. Misra, D.T. Felson, K.M. Crossley, and E.M. Roos. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Ou. Arthritis Care & Research 63(S11): S208–S228 (2011).
B. Eftekhar-Sadat, S.H. Niknejad-Hosseyni, A. Babaei-Ghazani, V. Toopchizadeh, and H. Sadeghi. Reliability and validity of Persian version of Western Ontario and McMaster Universities Osteoarthritis index in knee osteoarthritis. Journal of Analytical Research in Clinical Medicine 3(3): 170–177 (2015).
E.R. Vina, and C.K. Kwoh. Epidemiology of osteoarthritis: literature update. Current Opinion in Rheumatology 30(2): 160–167 (2018).
M. Tschon, D. Contartese, S. Pagani, V. Borsari, and M. Fini. Gender and Sex Are Key Determinants in Osteoarthritis Not Only Confounding Variables. A Systematic Review of Clinical Data. Journal of Clinical Medicine 10(14): 3178 (2021).
S. Basaran, R. Guzel, G. Seydaoglu, and F. Guler-Uysal. Validity, reliability, and comparison of the WOMAC osteoarthritis index and Lequesne algofunctional index in Turkish patients with hip or knee osteoarthritis. Clinical Rheumatology 29(7): 749–756 (2010).
F. Salaffi, G. Leardini, B. Canesi, A. Mannoni, A. Fioravanti, R. Caporali, G. Lapadula, and L. Punzi. Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee. Osteoarthritis and Cartilage 11(8): 551–560 (2003).
L.C. Walker, N.D. Clement, M. Bardgett, D. Weir, J. Holland, C. Gerrand, and D.J. Deehan. The WOMAC score can be reliably used to classify patient satisfaction after total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy 26(11): 3333–3341 (2018).
E. Roos, M. Klässbo, and L.S. Lohmander. WOMAC Osteoarthritis Index: Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Scandinavian Journal of Rheumatology 28(4): 210–215 (1999).
N.F. Woolacott, M.S. Corbett, and S.J.C. Rice. The use and reporting of WOMAC in the assessment of the benefit of physical therapies for the pain of osteoarthritis of the knee: findings from a systematic review of clinical trials. Rheumatology 51(8): 1440–1446 (2012).
L.C. Walker, N.D. Clement, M. Bardgett, D. Weir, J. Holland, C. Gerrand, and D.J. Deehan. Correction to: The WOMAC score can be reliably used to classify patient satisfaction after total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy 27: 340–340 (2019).
D.K. White, and H. Master. Patient-Reported Measures of Physical Function in Knee Osteoarthritis. Rheumatic Disease Clinics of North America 42(2): 239–252 (2016).
W. Steenkamp, P.A. Rachuene, R. Dey, N.L. Mzayiya, and B.E. Ramasuvha. The correlation between clinical and radiological severity of osteoarthritis of the knee. SICOT-J 8: 14 (2022).
K. Shimada, A. Komiya, N. Yokogawa, J. Nishino, S. Sugii, and S. Tohma. Impact of the size and number of swollen joints on serum C-reactive protein level and erythrocyte sedimentation rate in rheumatoid arthritis: a cross-sectional study in Japan. Clinical Rheumatology 36(2): 427–431 (2017).
M. Hanada, M. Takahashi, H. Furuhashi, H. Koyama, and Y. Matsuyama. Elevated erythrocyte sedimentation rate and high-sensitivity C-reactive protein in osteoarthritis of the knee: relationship with clinical findings and radiographic severity. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 53(Pt 5): 548–553 (2016).
D.C. Sanchez-Ramirez, M. van der Leeden, M. van der Esch, M. Gerritsen, L.D. Roorda, S. Verschueren, J. van Dieen, J. Dekker, and W.F. Lems. Association of serum C-reactive protein and erythrocyte sedimentation rate with muscle strength in patients with knee osteoarthritis. Rheumatology 52(4): 727–732 (2013).
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Upon acceptance of an article, its copyright will be assigned to the Pakistan Academy of Sciences.
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons Attribution (CC BY). Allows users to: copy the article and distribute; abstracts, create extracts, and other revised versions, adaptations or derivative works of or from an article (such as a translation); include in a collective work (such as an anthology); and text or data mine the article. These uses are permitted even for commercial purposes, provided the user: includes a link to the license; indicates if changes were made; gives appropriate credit to the author(s) (with a link to the formal publication through the relevant DOI); and does not represent the author(s) as endorsing the adaptation of the article or modify the article in such a way as to damage the authors' honor or reputation.