Prevalence, Risk Factors, and Quality of Life of Knee Osteoarthritis in Urban Community in Indonesia: A COPCORD Study
Pande Ketut KurniariRudy HidayatFaisal ParlindunganMirza Zaka PratamaSuryo Anggoro Kusumo WibowoSumariyono SarmidiCesarius Singgih WahonoBagus Putu Putra SuryanaPerdana Aditya RahmanRadiyati Umi PartanMuhammad ReaganSurya DarmaBlondina MarpaungAndi Raga GintingRizqi Arini SiregarGede KambayanaDewa Ayu Kartika TejawatiDwijo Anargha SindhughosaLaniyati HamijoyoAndri Reza RahmadiChevie WirawanYulia SofiatinNyoman KertiaLisa Kurnia SariRakhma Yanti HellmiIka Vemilia WarlistiFenda AditaYulyani WerdiningsihArief NurudhinIndrayana SunarsoMahriani SylvawaniRahmat ZuaidiDolly JazmiNajirman NajirmanRikarni RikarniMuhammad Agung Pratama YudhaNyoman SuarjanaDimas Hudy AriadieDjallalluddin DjallalluddinCahyo Wibisono NugrohoLita Diah RahmawatiFemi SyahrianiPaula HarmanSarafina ElwindyJeffrey OngkowijayaPande Putu JanuragaBrigitta Dhyah Kunthi WardhaniPutu Erma Pradnyani
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ABSTRACT Aim This study evaluates the prevalence, risk factors, and quality of life of patients with knee osteoarthritis (OA) in the Indonesian population. Method A cross‐sectional study of 3597 adults (≥ 18 years old) was conducted in 2023 involving 15 different cities in Indonesia. Knee OA was classified according to the clinical ACR criteria. The COPCORD questionnaire was used for all subjects. The quality of life (QoL) was assessed using the WOMAC score. Results The prevalence of knee OA was 15.0%. Banda Aceh has the highest prevalence of knee OA at 70.79%, whereas Bandung has the lowest (4.18%)—the odds of having knee OA increased with age. The adjusted odds ratio (aOR) were 5.01 (95% CI 2.47–10.15, p < 0.001) for participants aged 40–49 years and 72.19 (95% CI 36.32–143.51, p < 0.001) for participants aged 70 years or over, compared to participants under 40 years. Knee OA was higher among female participants (aOR = 1.91; 95% CI 1.53–2.39, p < 0.001). Married and divorced participants had higher odds of having knee OA compared to those who never married (aORs 2.56 (95% CI 1.37–4.77, p = 0.003) and 2.40 (95% CI 1.23–4.68, p < 0.010), respectively). Knee OA is less likely found among participants with elementary school education background (aOR 0.37; 95% CI 0.22–0.64, p < 0.001) and those with senior high school (aOR 0.49; 95% CI 0.29–0.83, p = 0.007). The total WOMAC score was 25.9 ± 18.7 from all participants, indicating moderate impairment in QoL. Conclusion The prevalence of knee OA in several urban districts in Indonesia was 15.0%, with most patients having moderate impairment in QoL. Several sociodemographic factors were associated with the odds of having knee OA.Keywords:
Cross-sectional study
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Aim: To evaluate the clinical and functional outcomes of using intra-articular hyaluronic acid injection to treat early osteoarthritis of the knee joint.Methods: The study included 25 patients with early osteoarthritis ranging from grade 0 to grade 2. Patients were evaluated before and after the procedure using the Visual Analogue Scale (VAS) and the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) at 1 month and 6 month follow up, respectively.The study group showed clinical improvement and excellent results, as evidenced by their VAS and WOMAC scores at 1 month and 6 month follow-up. In the study groups, no serious adverse effects were observed.Conclusions: Our study determined that hyaluronic acid injection is a safe and effective method in treating early osteoarthritis.
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Objectives. In older people Osteoarthritis (OA) and vitamin D deficiency are common health conditions. It controversial Whether vitamin D concentration is associated with knee OA or not. In this study, we aimed to determine the association between serum concentrations of vitamin D and osteoarthritic knee pain. Subjects and Methods. Vitamin D concentrations were measured with the 25 hydroxy vitamin D test in patients presenting with clinical symptoms of primary knee osteoarthritis. Osteoarthritis was graded on the Kellgren-Lawrence grading scale from anteroposterior and lateral radiographs. Height, weight, and body mass index (BMI) were recorded. Patients completed a 10-cm visual analogue scale (VAS) for indicating pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC).Vitamin D concentration was defined as severely deficient (<10 ng/mL), insufficient(10 to 19 ng/mL), or normal (20 to 50 ng/mL). Results. Of 149 patients (133 women), the mean age was 62.7 years. Mean vitamin D concentration was 10.93 ng/mL, and 89% patients were vitamin D deficient. Mean WOMAC score was 56.9, and VAS pain score was 7.5. Kellgren-Lawrence grade was 3 for 11 patients, grade 2 for 60, and grade 4 for 88. Mean BMI was 33.4. Mean values of VAS, WOMAC, and BMI did not differ by vitamin D status. Conclusion. Serum vitamin D concentration is not associated with knee pain in patients with osteoarthritis.
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Background
Osteoarthritis (OA) is the most common arthritis worldwide. OA ischaracterized by erosion and loss of articular cartilage accompanied by hypertrophic changes in neighboring bone that result in pain, stiffness, and gradual deterioration of mobility1. Nowadays is the most common cause of physical disability among older patients. Therefore, different instruments have been developed to evaluate the impact of OA on functioning and quality of life of patients, among them EQ-5D and WOMAC2Objectives
To determine the association and correlation among common subjective measuring toolsfor knee osteoarthritis: EQ, WOMAC and VASMethods
120 patients with radiologically confirmed knee osteoarthritis were evaluated with Visual Analogue Scale (VAS) for pain, Western Ontario and McMaster Osteoarthritis Index (WOMAC) for functional status, and EQ-5D for Health related quality of life. That measures werecompared and the concordance (Kappa Index) among the three guides calculatedResults
An 80% of the sample were women, mean (SD) age 64,11 (10,361) and BMI 31,40 kg/m2 (5,3). Radiographic severity mean (SD) was 2, 63 (0,685) and 75% had more affected joints besides knee. Mean (SD) standardized tools scores were: EVA 6,46 (2,3 SD); EQ-5D 0,58 (0,23); EQ-5D VAS 56,6 (16,9); WOMAC pain 8,97 (3,7); WOMAC stiffness 3 (2); WOMAC function 29,5 (12,8) and WOMAC global 41,5 (16,86). People who reported higher scores on EVA, did the same in pain, function and global areas of WOMAC and had worse scores in quality of life instrument (EQ-5D) likewise. EQ-5D and WOMAC had also a significant associationConclusions
The high degree of association between WOMAC and EQ suggests that only one of them would be enough to get general health status data. EVA was mismatched respect to the others instruments nevertheless, so it could be useful variable to add information. We would need inquireif the different point in time which every tool takes in account to collect patient information influences these resultsReferences
Sevick MA, Miller GD, Loeser RF, Williamson JD, Messier SP Xie F, Pullenayegum EM, Li SC, Hopkins R, Thumboo J, Lo NNValue HealthDisclosure of Interest
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Background: Osteoarthritis is the most common degenerative joint disease resulting in pain and altered joint function. Objective: We investigated the possible association between serum interleukin-6 and symptoms of knee osteoarthritis with regard to pain, stiffness, physical function, assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). We also examined the connections between serum interleukin-6 and radiographic severity in primary knee osteoarthritis patients. Methods: In this case-control study, fifty primary knee osteoarthritis patients and fifty age and sex matched controls were randomly recruited. Serum interleukin-6 levels were immunoassayed in patients’ and controls’ serum. Patients’ knee pain, stiffness and physical function were assessed by the respective subscales of the WOMAC Index. Standing anteroposterior radiographs of the knee joint were performed and graded with the Kellegren-Lawrence grade. Results: The mean serum IL-6 level was significantly higher in osteoarthritis patients (110.22 ± 46.98pg/ml) than controls (46.04 ± 12.34 pg/ml) (p=0.001). The WOMAC Index in patients ranged from 0 – 95 and the Kellegren-Lawrence score mean was 2.7 ± 0.76. There was a significant correlation between serum IL-6 levels and pain (r=0.595 p=0.001), physical function score (r=0.666, p=0.001)), and the radiographic score (r=0.799, p=0.001). Regression analysis showed that IL-6 level had a greater impact on both the WOMAC Index (p=0.005) and the Kellegren-Lawrence score (p=0.01). Conclusion: Serum IL-6 level is increased in primary knee osteoarthritis patients. Also, serum interlukin-6 is significantly related to osteoarthritis symptoms and radiographic severity.
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To compare the improvement of hip and knee osteoarthritis during treatment with naproxen.Men and women aged 40 to 75 years with symptomatic osteoarthritis of the knee or hip of at least three months' duration participated in a six week placebo controlled, double blind study with naproxen 500 mg twice daily as one treatment arm. Naproxen was given to 403 patients (280 knee, 123 hip) and placebo to 108 patients (75 knee, 33 hip). WOMAC (Western Ontario and McMaster Universities osteoarthritis index) 3.1 visual analogue scale and SF-36 (36 item short form health survey) were used to assess response to treatment between baseline and week 6.There were no differences at baseline between knee and hip osteoarthritis for any of the WOMAC subscales or SF-36 domains. Improvement was between 4 and 7 mm greater for knee than for hip for all WOMAC subscales (pain, delta = 4.7 mm (p = 0.03); stiffness, delta = 6.6 mm (p = 0.004); function, delta = 4.8 mm (p = 0.06)). Effect size was about 0.8 for all WOMAC subscales for the knee and between 0.5 and 0.6 for the hip. Knee patients treated with naproxen improved 4.6 (p = 0.033) more than hip patients for SF-36 bodily pain and 10.3 (p = 0.014) more for SF-36 role-physical.Patients with knee osteoarthritis improved more with naproxen treatment than patients with hip osteoarthritis, as monitored by WOMAC and the SF-36 domains bodily pain and role-physical. These findings warrant further investigation and strongly suggest that efficacy of treatment of osteoarthritis of knee and hip should be evaluated separately.
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Background: Prior trials investigating the treatment of symptomatic osteoarthritis (OA) with hyaluronic-acid-derived products injections have provided optimistic results. The study was directed to assess the effectiveness of an innovative hyaluronic-acid-based hydrogel (Hymovis®) in the treatment of symptomatic knee OA. Methods: A prospective, single-center, clinical trial was performed. Thirty-five patients with degenerative knee OA were included. Inclusion criteria were: age between 45–80, radiographic Kellgren grade II or III osteoarthritis, minimum 35 mm score on the Visual Analogue Scale (VAS), pain for at least 6 months and agreement to participate in the study. Patients received two injections at a one-week interval. The evaluator assessed the patients using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and VAS. Evaluation was performed before, at 2 and 6 months after the injections. Results: A significant improvement on the WOMAC Index pain subscale was observed at 6 months after the injection. At two months, pain subscale score decreased from 10.34 to 9.34. At six months, a significant decrement in pain parameters compared to baseline was observed (from 10.34 to 7.72; p = 0.0004). Median points on VAS significantly ameliorated after 6 months (from 74.2 to 57.3 cm; p < 0.0001). Regarding physical function, a statistically significant difference compared to baseline was observed at the end of the study (from 29.74 to 25.18; p = 0.0025). WOMAC Index stiffness component did not differ from baseline at any time during follow-up. Conclusions: Pain relief installed with a delayed on-set but had a prolonged duration. The novel hyaluronic acid-based hydrogel (Hymovis®) had effective results, particularly after six months post-injections and offers a therapeutic advancement in the treatment of moderate to severe osteoarthritis.
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Objective To evaluate the effect of combining photo-activation therapy with platelet-rich plasma injections for the novel treatment of osteoarthritis. Design We present a case report of osteoarthritis of the knee treated with photo-activated platelet-rich plasma injections (PAPRP). Methods After utilising conventional osteoarthritis treatment methods a patient underwent a course of PAPRP injections. The patient outcome was measured using the numerical pain rating scale (NPRS) and the Western Ontario and McMaster Universities Arthritis (WOMAC) Index. Results Following treatment the patient reported improvements in both pain and function as measured by the NPRS and WOMAC Index, respectively. The patient was followed up for 18 weeks, at which time no significant complications were noted. Conclusions In this case report of osteoarthritis, with strict control of conventional therapy variables, PAPRP injections demonstrated improvement in all recorded outcome measures. The results of this case report highlight the need to further investigate the use of PAPRP in the treatment of symptomatic knee osteoarthritis.
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Effectiveness of platelet-rich plasma (PRP) in the treatment of mild to moderate knee osteoarthritis
Aim: To assess the functional outcome of treatment of osteoarthritis knee joint by intra articular injection of platelet rich plasma.Methods: A total of 50 patients with grade 0 to grade 3 osteoarthritis knee joint were randomly selected and 2 doses of intraarticular injection of platelet rich plasma were given at interval of 1 month and the outcome was evaluated with visual analog scale (VAS) and the western Ontario and mcmaster universities arthritis index (WOMAC) at preinjection, 1,3 and 6 months interval. Results: The mean age of patients were 55.5. There were better improvements noted in VAS and WOMAC scale. Best scores were noted in 2 months interval. The scores got deteoriated over 6 months interval but the final scores were better than the pre injection scores. Two injection therapy gives better result than single injection therapy.Conclusion: Platelet rich plasma injection is effective in the treatment of osteoarthritis knee with minimum of two injections is appropriate therapies in treatment of osteoarthritis knee joint.
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