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| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 8
| Issue : 4 | Page : 84-87 |
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Clinical profile of patients with osteoarthritis at a tertiary care hospital
G Krishnamurthy1, Goutham Kumar2
1 Department of Orthopedics, Dhanalakshmi Srinivasan Medical College and Hospitals, Trichy, Tamil Nadu, India
2 Department of Orthopedics, Kamineni Institute of Medical Sciences, Nalgonda, Telangana, India
| Date of Submission | 01-Nov-2020 |
| Date of Decision | 09-Nov-2020 |
| Date of Acceptance | 10-Nov-2020 |
| Date of Web Publication | 25-Dec-2020 |
Correspondence Address:
Dr. Goutham Kumar
Department of Orthopedics, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/mjhs.mjhs_24_20
Background: Apart from the risk of morbidity and mortality from osteoarthritis, it has been noted that resources of the health care and the increased costs of the health care are consumed by the osteoarthritis. Studies are required on the clinical profile of patients with osteoarthritis which focus on different clinicoepidemiological characteristics, identifying risk groups in different settings.
Objective: The present study was carried out to study the clinical profile of patients with osteoarthritis at a tertiary care hospital.
Methods: A hospital-based cross-sectional study was carried out over a period of 1 year among 170 confirmed cases of osteoarthritis. Detailed history, thorough clinical examination, necessary investigations, and X-ray of the affected joint were taken in all cases. Data were analyzed using proportions. Chi-square test was applied.
Results: Females were more than males. The most commonly affected age group was 70–80 years in 35.3% of the cases. A linear trend is seen as per the age group with the least prevalence of osteoarthritis in the age group of 40–49 years, i.e., 12.9%–35.3% in the age group of 70–80 years. Most commonly involved were the small joints in 52.4% of the cases, followed by the knee joint in 38.8% of the cases and other joints in 8.8% of the cases. The most common occupation affected was laborer in 41.8% of the cases, followed by civil construction workers in 22.9% of the cases, supervisors in 20% of the cases, and executives in 17.6% of the cases.
Conclusion: Osteoarthritis was more common in Females than males. Osteoarthritis was more common in the elderly age group and laborers. Small joints were more commonly affected than the large joints.
Keywords: Knee joint, osteoarthritis, small joints
How to cite this article:
Krishnamurthy G, Kumar G. Clinical profile of patients with osteoarthritis at a tertiary care hospital. MRIMS J Health Sci 2020;8:84-7 |
| Introduction | |  |
Osteoarthritis leads to disability. In a study, a comparison was made on “activities of daily living impairments” and they found that it was 1.12–1.35 times more with cases having osteoarthritis than those without osteoarthritis. The number of years of life with disability was found out to be very high among old age males and females 836 and 3039 per 10,000, respectively, in Korea. Osteoarthritis was found out to be an important cause of taking sick leaves in Sweden.[1],[2]
Thus, osteoarthritis affects the physical health. However, it has been observed that it not only affects the physical health but it also affects the mental and psychological health of the people affected with the osteoarthritis. It has been observed that symptoms of depression are more common in those people with osteoarthritis compared to those who do not have osteoarthritis. It has also been found that osteoarthritis is associated with the risk of suicides. It has also been noted that a strong association exists between the memory loss which is perceived and the presence of osteoarthritis.[3],[4]
It has been noted that the risk of cardiovascular diseases increases with the presence of osteoarthritis. This has been confirmed in a meta-analysis study. Similarly, the risk of coronary heart disease increased with the presence of osteoarthritis. The risk of mortality from cardiovascular diseases also increases in people with osteoarthritis compared to people without osteoarthritis.[5],[6]
Apart from the risk of morbidity and mortality from osteoarthritis, it has been noted that resources of the health care and the increased costs of the health care are consumed by the osteoarthritis. There is more and more risk of getting admitted into the hospital with people having osteoarthritis compared to people without osteoarthritis.[7],[8]
Studies are required on the clinical profile of patients with osteoarthritis which focus on different clinicoepidemiological characteristics, identifying risk groups in different settings. Hence, the present study was carried out to study the clinical profile of patients with osteoarthritis at a tertiary care hospital.
| Methods | | |
Study design
This was a hospital-based cross-sectional study.
Study period
The study period was 1 year from August 2018 to July 2019.
Study place
The present study was carried out at the department of orthopedics of a tertiary care hospital.
Sample size
During the period of 1 year, it was possible to include 170 cases of osteoarthritis. These 170 cases of the osteoarthritis were recruited in the present study using convenient sampling technique.
Ethical considerations
The institution ethics committee permission was obtained after presenting the protocol of the present study. After approval, the data collection was done in the predesigned, pretested semi-structured study questionnaire which was prepared based on the extensive review of the literature. Written informed consent was obtained from all the study participants in the present study after they were explained about the nature of the study. Confidentiality was maintained. All cases were given appropriate treatment and follow-up.
Inclusion criteria
- Confirmed cases of osteoarthritis
- Age from 40 to 80 years of either sex
- Willing to participate in the present study.
Exclusion criteria
- Age <40 years and >80 years
- Cases of osteoarthritis with severe comorbidities.
Methodology
Whenever a person with joint pains reported to the outpatient department of orthopedics, a thorough history and detailed clinical examination was carried out to confirm the presence of osteoarthritis supported by necessary investigations. After the case was confirmed as having osteoarthritis, the person was explained in detail about the nature of the present study and then their willingness was asked if they wanted to participate in the present study. If they accepted, then the written informed consent was taken in the local language.
A detailed history, thorough clinical examination, was carried out and the data were recorded in the predesigned, pretested, semi-structured study questionnaire which was prepared based on the extensive review of the literature. Necessary investigations were carried out in all cases. X-ray of the affected joints was taken in anteroposterior and lateral view. Appropriate treatment was given.
Statistical analysis
The data were entered in the Microsoft Excel worksheet and analyzed using proportions. Chi-square test was applied. P < 0.05 was considered as statistically significant.
| Results | | |
[Table 1] shows the distribution of the study participants as per age and sex. Females were more than males. The most commonly affected age group was 70–80 years in 35.3% of the cases, followed by 60–69 years in 30% of the cases. A linear trend is seen as per the age group with the least prevalence of osteoarthritis in the age group of 40–49 years, i.e., 12.9%–35.3% in the age group of 70–80 years.
[Table 2] shows the distribution of the study participants as per the type of joint involved. Most commonly involved were the small joints in 52.4% of the cases, followed by the knee joint in 38.8% of the cases and other joints in 8.8% of the cases. In males, small joint affection was seen in 52.7% of the cases, followed by the knee joint in 40.5% of the cases and other joints in 6.6% of the cases. In females, small joints were found to be affected in 52.1% of the cases, followed by the knee joint in 37.5% of the cases and other joints in 10.4% of the cases. | Table 2: Distribution of the study participants as per the type of joint involved
Click here to view |
[Table 3] shows the distribution of patients with osteoarthritis as per their occupation. The most common occupation affected was laborer in 41.8% of the cases, followed by civil construction workers in 22.9% of the cases, supervisors in 20% of the cases, and executives in 17.6% of the cases. In males, laborer occupation was most commonly affected in 40.5% of the cases, followed by civil construction workers in 24.3% of the cases, supervisors in 20.3% of the cases, and executives in 14.9% of the cases. In females, laborer occupation was most commonly affected in 42.7% of the cases, followed by civil construction workers in 21.9% of the cases, supervisors in 17.7% of the cases, and executives in 17.7% of the cases. | Table 3: Distribution of patients with osteoarthritis as per their occupation
Click here to view |
| Discussion | | |
Females were more than males. The most commonly affected age group was 70–80 years in 35.3% of the cases, followed by 60–69 years in 30% of the cases. A linear trend is seen as per the age group with the least prevalence of osteoarthritis in the age group of 40–49 years, i.e., 12.9% to 35.3% in the age group of 70–80 years. Most commonly involved were the small joints in 52.4% of the cases, followed by the knee joint in 38.8% of the cases and other joints in 8.8% of the cases. In males, small joint affection was seen in 52.7% of the cases, followed by the knee joint in 40.5% of the cases and other joints in 6.6% of the cases. In females, small joints were found to be affected in 52.1% of the cases, followed by the knee joint in 37.5% of the cases and other joints in 10.4% of the cases. The most common occupation affected was laborer in 41.8% of the cases, followed by civil construction workers in 22.9% of the cases, supervisors in 20% of the cases, and executives in 17.6% of the cases. In males, laborer occupation was most commonly affected in 40.5% of the cases, followed by civil construction workers in 24.3% of the cases, supervisors in 20.3% of the cases, and executives in 14.9% of the cases. In females, laborer occupation was most commonly affected in 42.7% of the cases, followed by civil construction workers in 21.9% of the cases, supervisors in 17.7% of the cases, and executives in 17.7% of the cases.
Akkimaradi and Mohan Kumar[9] observed that females were more than males and we also found that females were more than males in the present study. Thus, it can be said that females are more commonly affected than males by the disease called osteoarthritis. The age group in the authors' study ranged from 44 to 80 years and we also studied the similar age group for the study of osteoarthritis ranging from 40 to 80 years. Thus, osteoarthritis can be commonly seen in the age group of 40 and above and its prevalence increases as the age increases. The authors found that out of 72 knees, i.e., in 65 patients, 50 cases became free of pain in the affected joints after the follow-up period of more than 1 year. Fifteen of the cases had pain in the joints even after the follow-up period. Among these 15 cases, it was observed that 11 cases had only complained of pain which was occasional. Four cases complained of pain while they were using the staircase. The authors also observed that the range of movements also increased.
Shakoor et al.[10] studied the clinical profile of 162 patients with osteoarthritis. They used the “American College of Rheumatology” to include the patients. They found that males were more than females, which is in contradiction to the findings of the present study where we found that females were more than males. The authors noted that the average of the cases of the osteoarthritis was 53.73 ± 11.35 years which confirmed the finding of the present that osteoarthritis is more common in the elderly age groups. Majority of their patients were in the age group of 50–59 years, whereas in the present study, we found that majority of the study participants were in the age group of 70–80 years. The authors noted that 68.5% of the cases of the osteoarthritis were belonged to the middle class and 35.8% of the cases of the osteoarthritis were housewives. The average symptoms of osteoarthritis duration were 25.25 ± 38.85 months. Pain onset was gradual in 87.7% of the cases. About 90.1% of the cases had not given the history of morning stiffness. Thus, the authors concluded that osteoarthritis was more common in males, but the onset was earlier in females.
Racaza et al.[11] studied 859 cases with primary osteoarthritis. Females were found to be three times more compared to males. This finding is in accordance with the finding of the present study that females are more commonly affected compared to the males by osteoarthritis. The average age of onset of osteoarthritis was found out to be 63 years, which also is in accordance with the finding of the present study where we found more cases in the elderly age groups compared to the younger age groups. The average of the body mass index indicated that overweight was present. Women were more overweight than males, but males were more obese than females. Fifty-three percent had hypertension, 16% had dyslipidemia, and 13% had diabetes. Cases belonging to the lower social class were found out to be one-third of the total study participants. About 92.8% of the cases of the osteoarthritis complained of the presence of pain. About 70.8% of the cases had crepitus, 13% had Heberden's nodes. The knee joint was most commonly affected in 62.5% of the cases, whereas we found in the present study that small joints were commonly affected than knee joints.
Castaño Carou et al.[12] noted that the average age was 68.0 ± 9.5 years and females were more affected than males. This finding is in accordance with the finding of the present study that females are more commonly affected compared to the males by osteoarthritis. The prevalence of obesity was found to be 47.6% of the cases. The knee joint was most commonly affected in 84.3% of the cases, whereas we found in the present study that small joints were commonly affected than knee joints. All cases complained of pain. Sixty-six percent of the cases gave the presence of the family history of osteoarthritis. About 55.1% of the cases had hypertension.
| Conclusion | | |
Females were more affected than males with osteoarthritis, and it was more common in the elderly age group, laborers, and small joints This finding was more commonly affected.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]
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