Studyknee with locomotor disability in the Rotterdam Associations of radiological osteoarthritis of the hip

Objective—To assess the contribution of radiological osteoarthritis of the hips and knees to disabilities in the activities of daily living related to lower limb function. Methods—During a home interview 1156 men and 1739 women, randomly chosen from the source population of all independently living residents aged 55 years and over living in a district of Rotterdam (the Rotterdam Study) were asked about locomotor disability by six questions of the Health Assessment Questionnaire (HAQ) and about pain in the hips and knees in the past month. Radiographs of hips and knees were scored according to the Kellgren grading system for osteoarthritis. Results—The prevalence of locomotor disability, defined as at least some diYculty with three or more out of six lower limb functions, was 20.2% for men and 31.9% for women; hip pain was present in 8.3% of the men and 16.6% of the women; knee pain in 12.6% of the men and 22.3% of the women. The prevalence of radiological osteoarthritis grade 2+ of the hip was 14.1% for men and 15.9% for women, and of the knee 16.3% and 29.1% respectively. The odds ratio (OR) (95% confidence intervals) of hip radiological osteoarthritis for locomotor disability adjusted for age and all other variables was for men: 1.4 (0.9, 2.1) and for women: 2.2 (1.6, 2.9). The ORs of knee radiological osteoarthritis adjusted for age and all other variables were 1.1 (0.9, 2.1) and 1.4 (1.1, 1.8) respectively. Severe radiological osteoarthritis (grade 3+) was stronger associated. The ORs of pain in the hips or knees and morning stiVness were much higher (between 2.7 and 5.5 for men and between 2.1 and 5.1 for women). Conclusions—Radiological osteoarthritis of the hip and knee are only weak independent predictors of locomotor disability in women, and not at all independently associated with locomotor disability in men. Age, pain of the hips and knees, and morning stiVness seem to be the most important independent determinants of locomotor disability. (Ann Rheum Dis 1998;57:203–208) Locomotor disability as defined by the diYculty people experience when carrying out basic activities of daily living related to the lower limbs can be caused by many diseases. In a recent paper we demonstrated the association between locomotor disability and joint pain and morning stiVness. In the elderly radiological osteoarthritis of the hip and knee is often related to joint pain andmorning stiVness. This paper analysed the eVect of radiological osteoarthritis on the occurrence of locomotor disability. Data from the National Health and Nutrition Examination Survey-I Epidemiologic Follow-up Study (NHEFS) and the Framingham Study suggested a large impact of radiological osteoarthritis of the knee on disability in the activities of daily living related to lower limb function. More recently a British study reported an increased risk of locomotor disability in people with pain and radiological osteoarthritis of the knees. 8 However, data on the influence of pain or radiological osteoarthritis of the hip are lacking. This study analysed in 2985 people of the Rotterdam Study cohort the association between radiological osteoarthritis and self reported pain in the hips and knees and locomotor disability.