The Effect of Pregnancy and Body Mass Index in Patients With Knee Osteoarthritis

Abstract

OBJECTIVE: To evaluate the association between knee osteoarthritis and either body mass index BMI or pregnancy in women.METHODS: 88 patients with average age of 60,4 40-88 years were evaluated. Age, weight, height, and number of pregnancy of the patients were recorded. Radiographic staging was detected from Anterior Posterior- Lateral radiographs of the knee. WOMAC OA index The Western Ontario and Mcmaster Universities Osteoarthritis Index and Lequesne Knee Osteoarthritis severity scores were used to investigate clinical scoring.RESULTS: The mean BMI was 28,3 19,8- 42,7 . The mean pregnancy was 7 0-13 . According to Kellgren-Lawrance staging system; 2 Patients were stage 1, 37 were stage 2, 36 were stage 3 and 13 were stage 4. The mean total WOMAC OA score of the patients was 66,7 22-91 , while the mean pain score was 13,2 4-20 , Stiffness was 4,8 2-8 , function was 48,6 16-65 . The mean Lequesne score was 13,9 5- 23 , pain was 5,2 2-8 , mean walking distance was 4 1-7 and the mean daily activity score was 4,6 1-8 . There was statistically significant positive correlation between age and WOMAC total, pain, function, Lequesne total, walking distance scores while there was no statistically significant between WOMAC stiffness, Lequesne pain, daily activity scores. With respect to BMI and pregnancy all parameters except WOMAC total score were statistically significant positive correlated with either BMI or pregnancy.CONCLUSION: Degeneration in the knee joint increases and quality of life decreases with increasing of age, BMI, pregnancy.

Keywords

• Pregnancy,Gonartroz,Body mass index

Diz Osteoartriti Olan Hastalarda Gebelik Ve Vücut Kitle İndeksinin Etkisi

Abstract

AMAÇ: Kadınlarda diz osteoartriti gonartroz ile vücut kitle indeksi VKİ , doğum sayısı ve yaş gibi değişkenlerin ilişkisini araştırmakYÖNTEMLER: Kliniğimize başvuran ve gonartroz tanısı alan ortalama yaşları 60,4 40-88 yıl olan 88 hasta değerlendirmeye alınmıştır. Hastaların yaşları, kilo ve boy değerleri, doğum sayıları, kaydedilmiştir. Şikayeti olan diz için AP-Yan grafilerinden radyolojik evreleme, WOMAC OA indeksi The Western Ontario and Mcmaster Universities Osteoarthritis İndeks ve Lequesne Diz Osteoartrit Şiddet İndeksi kullanılarak skorlama yapılmıştır.BULGULAR: Çalışmada değerlendirilen 88 kadın hastanın ortalama VKİ’ leri 28,3 19,8- 42,7 idi. Ortalama doğum sayısı ise 7 0-13 . Kellgren-Lawrance evreleme sistemine göre 2 hasta evre 1, 37 evre 2, 36 evre 3, 13 hasta ise evre 4 idi. Hastaların ortalama toplam WOMAC OA skorları 66,7 22-91 iken WOMAC Ağrı skoru ortalama 13,2 4-20 , Tutukluluk ortalama 4,8 2-8 , fonksiyon ortalama 48,6 16-65 . Lequesne ağrı skoru ortalama 5,2 2-8 , yürüme mesafesi ortalama 4 1-7 , günlük aktivite ortalama 4,6 1-8 iken toplam Lequesne skoru ise ortalama 13,9 5- 23 idi. Hastanın yaşı ile WOMAC toplam, ağrı ve fonksiyon, Lequesne toplam ve yürüme mesafesi skorları arasında istatistiki olarak anlamlı ve pozitif korelasyon bulunurken, WOMAC tutukluluk, Lequesne ağrı, günlük aktivite skorları arasında anlamlı korelasyon bulunmamıştır. VKİ ile WOMAC toplam skor haricindeki tüm parametrelerde istatistiki olarak anlamlı pozitif ilişki bulunmuştur. Doğum sayıları incelendiğinde Doğum sayısı arttıkça yine WOMAC toplam skor haricindeki tüm parametrelerde istatistiki olarak anlamlı dercede artış olmaktadırSONUÇ: VKİ, yaş ve doğum oranı arttıkça diz ekleminde dejenerasyon artmakta ve yaşam kalitesi azalmaktadır.

Keywords

• Doğum,Gonartroz,Vücut kitle indeksi

References

1. Felson DT. The epidemiology of hip and knee osteoar- thritis. Epidemiol Rev 1988; 10:1-28.
2. Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, Liang MH, Pillemer SR, Steen VD, Wolfe F. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthri- tis Rheum 1998; 41:778-99.
3. Dıraçoglu D, Aydın R, Baskent A. Saglıklı Kisilerde ve Diz Osteoartritli Hastalarda Propriosepsiyon Duyusu- nun Karsılastırılması. Türk Fiz Tıp Rehab Derg 2005; 51: 90-93.
4. Brandt KD, Flusser D: Osteoarthritis , In prognosis in the Rheumatic Diseases, ed N Bellamy. Kluwer Aca- demic Publishers; Lanchester, UK 11, 1991: 311-17.
5. Wei S, Venn A, Ding C, Martel-Pelletier J, Pelletier JP, Abram F, Cicuttini F, Jones G. The associations be- tween parity, other reproductive factors and cartilage in women aged 50-80 years. Osteoarthritis Cartilage 2011;19:1307-13.
6. Henry J, Mankin D: Pathogenesis of Osteoarthritis. In Kelley’s Textbook of Rheumatology, sixth edition, vol- ume II, Saunders Company, 2001:120-131.
7. Dennisson E,Cooper C: Osteoarthritis:Epidemiology and classification, In Rheumatology, ed Mosby,2003: 147-51.
8. Kellgren JH, Lawrence JS. Radiologic assessment of osteoarthritis. Ann Rheum Dis 1987; 16: 494-501.

9. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip and knee. J Rheumatol 1988; 15: 1833-40.
10. Bellamy N, Buchanan WW, Chalmers A, Ford PM, Kean WF, Kraag GR, Gerecz-Simon E, Campbell J. A multicenter study of tenoxicam and diclofenac in pa- tients with osteoarthritis of the knee. J Rheumatol 1993; 20: 999-1004.
11. Bellamy N, Kean WF, Buchanan WW, Gerecz-Simon E, Campbell J. Double-blind randomized controlled trial of sodium meclofenamate (Meclomen) and diclofenac sodium (Voltaren): post validation reapplication of the WOMAC Osteoarthritis Index. J Rheumatol 1992; 19; 153-9.
12. Lequesne MG, Samson S. Indices of severity in osteo- arthritis of weight. J Rheumatol, 1991; 18: 16-18.
13. Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences preva- lence, incidence and severity of osteoarthritis. Osteo- arthritis Cartilage 2005;13:769-81.
14. Arden N, Nevitt MC. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol 2006; 20: 3-25.
15. Grecomoro G, Piccione F, Letizia G: Therapeutic syn- ergism between hyaluronic acid and dexamehasone in the intraarticular treatment of the knee. Curr Med Res Opin 1992;13:49-55.
16. Felson DT, Zhang Y, Hannan MT, Naimark A, Weiss- man B, Aliabadi P, Levy D. Risk factors for incident ra- diographic knee osteoarthritis in the elderly: the Framingham study. Arthritis Rheum 1997; 40: 728-33.
17. Hepgüler S, Sahin Y, Barıs M, Aksit R. Gonartrozlu Hastalarda Klinik Bulgularda Çesitli Yasam Kalitesi Ölçümleri Arasındaki ilişkiler. Türk Fiz Tıp Rehab Derg 1998; 44: 61-8.
18. De Miguel Mendieta E, Cobo Ibanez T, Uson Jaeger J, Bonilla Hernan G, Martin Mola E. Clinical and ultraso- nographic findings related to knee pain in osteoarthri- tis. Osteoarthritis Cartilage 2006; 14: 540-4.
19. Richette P, Corvol M, Bardin T. Estrogens, cartilage, and osteoarthritis. Joint Bone Spine. 2003; 70:257-62.