Abstract
BackgroundThis study aimed to investigate the relationship between radiological severity, as assessed by the individual grades and grouped grades (grades “0 and 1” and “2 to 4”) of the Kellgren-Lawrence scale (K&Ls), and depression symptoms, cognitive loss, risk of falls, and quality of life in relation to knee osteoarthritis, as assessed by other instruments.MethodsData recorded between 2013 and 2014 in Amparo (São Paulo, Brazil) were retrieved for analysis. A total of 181 elderly patients who had knee osteoarthritis and underwent a radiologic exam were evaluated for depressive symptoms, cognitive loss, quality of life, and risk of falls by the Geriatric Depression Scale (GDS), Mini-Mental State Examination (MMSE), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), timed up and go test (TUG), and Berg balance scale (BBS). For statistical analyses, Fisher’s exact test, Mann-Whitney test, Kruskal-Wallis test, and Spearman’s coefficient analysis were used.ResultsThere was no significant relationship between the scores of the instruments investigated and the individual K&Ls grades. However, when the K&Ls scores were assessed by groups, grades “2 to 4” were associated with the worst WOMAC score and the highest frequency and risk of falls according to the BBS but not according to TUG. For the GDS and MMSE, no significant relationships with the K&Ls grades were found. In addition, the K&Ls grade was correlated with the WOMAC score, regardless of the domain.ConclusionThe radiological scores of the Kellgren-Lawrence (K&L) scale were associated with poorer WOMAC and BBS scores only when the K&Ls scores were evaluated in groups, and the WOMAC score was associated with an increase in the radiological grade.
Highlights
Knee osteoarthritis (KOA) is a chronic, low-grade, inflammatory form of arthritis that affects all joint structures, such as the hyaline cartilage, synovial membrane, and subchondral bone, as well as other joint tissues; it is considered one of the main causes of physical disability inSince KOA has multiple characteristics, both morphological and symptomatic, it is diagnosed and its progression is monitored on the basis of positive joint symptomsRibeiro et al Arthritis Research & Therapy (2020) 22:187 and radiologic typical findings of the disease [4, 5], and its treatment must be based on a multifactorial approach [1, 2, 6]
When the Kellgren-Lawrence scale (K&Ls) scale grades were divided into two groups, classified by the presence or absence of knee osteoarthritis (KOA), 69 and 112 subjects were included in the grades 2 to 4 and grades 0 and 1 groups, accounting for 38.12% and 61.88% of the study population, respectively
Regarding cognitive loss and its association with K&L grades, our results differed from the findings reported by Yoshimura et al [14], which suggested there are significantly lower Mini-Mental State Examination (MMSE) scores in individuals with radiological KOA than is those without radiological KOA
Summary
Knee osteoarthritis (KOA) is a chronic, low-grade, inflammatory form of arthritis that affects all joint structures, such as the hyaline cartilage, synovial membrane, and subchondral bone, as well as other joint tissues; it is considered one of the main causes of physical disability inSince KOA has multiple characteristics, both morphological and symptomatic, it is diagnosed and its progression is monitored on the basis of positive joint symptomsRibeiro et al Arthritis Research & Therapy (2020) 22:187 and radiologic typical findings of the disease [4, 5], and its treatment must be based on a multifactorial approach [1, 2, 6]. According to Felson [7], the more severe the radiological grade, as assessed by the Kellgren-Lawrence (K&L) scale, the greater the probability is that the patient presents with knee OA symptoms. This scale grades radiological severity on a scale from 0 to 4 on the basis of changes in the joint, such as the appearance of osteophytes, the narrowing of the joint space, sclerosis subchondral bone, and deformities [8]. This study aimed to investigate the relationship between radiological severity, as assessed by the individual grades and grouped grades (grades “0 and 1” and “2 to 4”) of the Kellgren-Lawrence scale (K&Ls), and depression symptoms, cognitive loss, risk of falls, and quality of life in relation to knee osteoarthritis, as assessed by other instruments
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