Association of Radiological Grading with Clinical Variables and Functional Status in Patients with Hip and Knee Osteoarthritis

Objective: The general opinion is that there is a disparity between symptoms and radiological abnormalities in osteoarthritis (OA), but some recent studies emphasize the potential contribution of underlying joint disease to the degree of pain and disability. Our aim was to assess the relationship between radiographic grading and demographic features, clinical variables and functional status in patients with hip and knee OA. Material and Methods: 128 patients (61.8 +/- 9.5 years, 84 knee and 44 hip OA) were included in the study. Demographic features, duration of disease and stiffness, and severity of pain were assessed using visual analog scale (VAS). Range of motion (ROM) measurements and radiological grading were performed. Western Ontario and McMaster Universities OA Index (WOMAC) was used for evaluating pain, stiffness and physical functions, and Short Form-36 (SF-36) was used for evaluating general health status. These variables were compared between three groups based on Kellgren-Lawrence radiological grades (grade 2, 3, 4). Results: Age, body mass index, ROM values, VAS (p = 0.0001), WOMAC pain, function and total score (p = 0.007, p = 0.03 and p = 0.03 respectively), physical functioning, bodily pain, social functioning and emotional role of SF-36 (p = 0.007, p = 0.008, p = 0.02 and p = 0.009 respectively) were worsened according to radiological grade in knee OA. Duration of disease, ROM values, VAS (p = 0.006) and bodily pain subscale of SF-36 (p = 0.03) were worsened in hip OA; no significant difference was detected in WOMAC subscales and total score. Conclusion: Clinical variables, functional status and quality of life deteriorated with radiological grade in knee OA patients and this deterioration was significant in grade 4. However, this association, especially of functional status, could not be confirmed in hip OA patients.