Type of Article : Original Research
Year: 2016 | Volume 4 | Issue 3 | Page No. 1518-1523
Date of Publication: 11-06-2016
ASSOCIATION OF PAIN, FUNCTION, BMI AND RADIOGRAPHIC EVIDENCE OF OSTEOARTHRITIS WITH CLINICAL ASSESSMENT OF OSTEOARTHRITIS OF THE KNEE JOINT
Santosh Metgud 1, Supriya Kondal *2, Anand Heggannavar 3.
1 Associate Professor, Head of Department-Department of Orthopaedic Manual Therapy, KLE University Institute of Physiotherapy, Belagavi, Karnataka, India.
*2 Post Graduate student-Department of Orthopaedic Manual Therapy, KLE University Institute of Physiotherapy, Belagavi, Karnataka, India.
3 Assistant Professor, Department of Orthopaedic Manual Therapy, KLE University Institute of Physiotherapy, Belagavi, Karnataka, India.
Corresponding author: Dr. Supriya Kondal, PT., Post Graduate student-Department of Orthopaedic Manual Therapy, KLE University Institute of Physiotherapy, Belagavi, Karnataka, India.
Background: Osteoarthritis (OA) of the knee joint is a highly prevalent musculoskeletal disorder that presents with varying signs and symptoms. Radiological and clinical assessment is routinely used to diagnose and treat osteoarthritis. Establishing a relationship between the signs and symptoms with its assessment needs to be done in order to find the efficacy to relate to patient’s symptoms.
Objectives: To find the correlation between pain, Body Mass Index (BMI), function and clinical assessment of OA knee. To find the correlation between radiographic evidence and clinical assessment of OA knee.
Materials and Methods: 60 individuals suffering from osteoarthritis of the knee were screened for BMI, pain score, Q-angle, radiographic features and functional disability.
Results: The correlation coefficient between BMI and Q-angle was -0.03 and 0.19 for right and left respectively whereas that between Pain and Q-angle was 0.14 and 0.15. Correlation between Objective and Functional scores on the Knee Society Score for right and left knees and Q-angle were -0.11, 0.17, -0.3, -0.09 respectively. There was no association found between radiographic evidence and clinical assessment of osteoarthritis of knee joint.
Discussion: The quadriceps muscle is an extra-articular structure that may be a negligible source of pain in osteoarthritis. Therefore the measurement of angle of pull of the muscle may not correlate with pain intensity. Compensatory changes occurring in the initial stages of obesity may not have a direct impact on the Q-angle. Continuation of functional activities in spite of pain may reduce correlation between function and Q-angle assessment. Variability in presenting features and radiographic evidence in our study has been supported by many studies.
Conclusion: Our study concludes that clinical signs and symptoms are highly variable and have a poor correlation with radiological and clinical assessment.
Clinical Implication: Measurement of Q-angle may not be a reliable tool in the assessment of OA knee and therefore a reliable and diagnostic tool should be made with respect to patient’s signs and symptoms.
Key Words: Knee Osteoarthritis, BMI, Knee Pain, Radiographs, Q-angle.
- M.S. Radha and M.R. Gangadhar. Prevalence of knee osteoarthritis patients in Mysore city, Karnataka. International Journal of Recent Scientific Research. 2015 April;6(4): 3316-20.
- Anna Litwic, Mark Edwards, Elaine Dennison, Cyrus Cooper. Epidemiology and Burden of Osteoarthritis. Br Med Bull. 2013;105:185–199.
- Keith K.W. Chan and Ricky W.K. Wu. Symptoms, Signs and Quality of Life (QoL) in Osteoarthritis (OA). Principles of Osteoarthritis – Its Definition, Character, Derivation and Modality-Related Recognition. 2012.
- Ajediran I. Bello*, Jeffrey A.Danso, Emmanuel Bonney, Oppong-Yeboah Bertha. The Influence of Body Mass Index, Q-angle and Tibiofemoral Alignment on the Clinical Deficits of Osteoarthritis of the Knee. J Physical Rehab Med. 2015;1(1):005.
- Be´laSzebenyi, Anthony P. Hollander, Paul Dieppe, Brian Quilty, John Duddy, Shane Clarke, and John R. Kirwan. Obj. Associations between Pain, Function, and Radiographic Features in Osteoarthritis of the Knee. Arthritis & Rheumatism. 2006 Jan;54(1):230–35.
- Venus Pagare. Visual analogue scale [internet]. Available from: "http://www.physio-pedia.com/Visual_Analogue_Scale".
- Ana Luiza Cabrera Martimbianco, Fernanda Rizzo Calabrese, Luiz Alberto Nakao Iha, Marcelo Petrilli, Ozório Lira Neto, and Mário Carneiro Filho. Reliability of the "American Knee Society Score" (AKSS). Acta Ortop Bras. 2012;20(1):34–38.
- Dr Henry Knipe and Dr Vivek Pai et al. Kellgren and Lawrence system for classification of osteoarthritis of knee [internet]. Available from: http://www.Radiopedia.org
- Carol A. Oatis. Kinesiology-The mechanics and pathomechanics of Human Movement. Second Edition. Lippincott Williams and Wilkins. 2009;772-774.
- Masahiko Ikeuchi, Masashi Izumi, Koji Aso, Natsuki Sugimura and Toshikazu Tani. Clinical characteristics of pain originating from intra-articular structures of the knee joint in patients with medial knee osteoarthritis. Springer Plus 2013;2:628.
- Narinder Kaul and S.K. Verma. Quadriceps Strength of Patients of Osteoarthritis Knee: Relationships to Pain and Disability. Journal of Exercise Science and Physiotherapy 2005; 1(1,2):38-45.
- Sheila C O’Reilly, Adrian Jones, Ken R Muir, Michael Doherty. Quadriceps weakness in knee osteoarthritis: the effect on pain and disability. Ann Rheum Dis 1998;57:588-594.
Santosh Metgud, Supriya Kondal, Anand Heggannavar. ASSOCIATION OF PAIN, FUNCTION, BMI AND RADIOGRAPHIC EVIDENCE OF OSTEOARTHRITIS WITH CLINICAL ASSESSMENT OF OSTEOARTHRITIS OF THE KNEE JOINT. Int J Physiother Res 2016;4(3):1518-1523. DOI: 10.16965/ijpr.2016.123