Correlates of radiographic changes in Nigerian patients with osteoarthritis of the knee

Abstract

Background:To determine the relationship between age, gender,and duration of Knee Osteoarthritis and radiographic changes using the Kellgren – Lawrence (K – L) grading.

Methods:The study was retrospective and cross-sectional.We reviewed the case notes of patients with knee osteoarthritis attending a  rheumatology clinic in Lagos over a ten year period,looking at their ages,gender,disease duration,K-L grading and deformities from radiological reports.

Results:Three hundred and eighteen patients were studied, of which 261(82.08%) were females.Their ages range between 31 and 91 years, with a mean of 60.92±10.96.The least duration of complaints at the time of presentation was 1.5 months, the longest 348 months, with a median of 48 months. Right knee joint alone was affected in 31 (9.84%), left knee in 21(6.67%), and both in 263 (83.49%) patients.The right knee joint alone was affected in 31 (9.75%) patients,left knee in 21(6.60%) patients,and both knees in 266 (83.65%) patients.Six patients (1.89%) had K-L grade 0,12 had 1 (3.77%),168 had 2 (52.83 %),107 had 3 (33.65%),and 25 (7.86%) had K-L grade 4. Deformities noted in 32 patients, among which Genu valgus seen in 18 (56.25%), Genu Varus in 11 (34.38%), and fixed flexion deformities in 1 patient (3.13%); both Valgus and Varus in 1 patient (3.13), and both Varus and Fixed flexion deformities in 1 patient(3.13%). Among patients who were 44yrs and below,19 (79%) had K-L grade II;while in those 65yrs and above, 57 (44%) had grade III, with a p value of 0.00. But there were no statistically significant differences in K-L grading between males and females, and between K-L grading withdeformities, or with the duration of knee OA at the time of presentation (p> 0.05).

Conclusion:This study,as in previous ones,showed that the age of the patient with knee OA is directly proportional to the likely severity of the K-L radiographic grading, but not with disease duration.

Key Words: Knee Osteoarthritis,Relationships,Kellgren – Lawrence (K – L) grading