The relationship between mental health/physical activity and pain/dysfunction in working-age patients with knee osteoarthritis being considered for total knee arthroplasty: a retrospective study

Abstract

Background Increasing total knee arthroplasty (TKA) surgeries are being performed on working-age patients with prominent manifestations of pain and dysfunction. But few studies have explored the risk factors for pain and dysfunction in working-age patients with knee osteoarthritis (KOA) being considered for TKA. Therefore, this study sought to explore the relationship between mental health/physical activity and pain/dysfunction in working-age patients with KOA being considered for TKA. Methods This study was a secondary analysis of data derived from a public database, the Work participation In Patients with Osteoarthritis cohort study, which included 152 working-age patients (65 men and 87 women) with KOA planning for TKA. We analyzed preoperative data comprising age, educational level, body mass index (BMI), mental factors (Patient Health Questionnaire-9 [PHQ-9] and the 36-Item Short Form Survey Instrument [SF-36 mental health]), physical activity level, and clinical outcomes (the Western Ontario and McMaster Universities Osteoarthritis Index and SF-36 sub-item score). Multivariate regression analysis was performed to determine risk factors for pain and dysfunction in working-age patients with KOA being considered for TKA. Results Women had lower pain, worse function, and higher PHQ-9 scores than men (p < 0.001). The depression scores were significantly linearly related to pain and function scores in women after adjusting for age, BMI, educational level, and physical activity (P < 0.05), whereas this relation was not observed in men. After adjusting for age, BMI, educational level, and mental factors, exercise time was found to be positively correlated with pain scores in women (P < 0.05). Conclusions Depression scores and exercise time were significantly correlated with pain and dysfunction in working-age women with KOA being considered for TKA.

Radiographic knee osteoarthritis severity has no impact on fall risk: the locomotive syndrome and health outcomes in the aizu cohort study (LOHAS): a cross-sectional study

“…An association between KOA and the risk of falls has been reported in cross-sectional studies [ 11 – 14 ], prospective cohorts [ 15 – 18 ], and longitudinal studies [ 19 – 23 ] (Table 1 ), but the results are inconsistent and controversial [ 17 ]. Although the diagnosis of KOA is often based on the combination of plain radiographs and subjective symptoms, several studies have described the involvement of psychological factors such as depression in the severity of symptoms and physical function in patients with KOA [ 24 ]. The need to consider psychological factors in assessing the association between KOA and falls has been addressed [ 13 ], but we found no published investigation of the impact of radiographic KOA severity on fall risk that also takes into account psychological factors.…”

Radiographic knee osteoarthritis severity has no impact on fall risk: The Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study (LOHAS): a cross-sectional study

“…An association between KOA and the risk of falls has been reported in cross-sectional studies [11][12][13][14] , prospective cohorts [15][16][17][18] , and longitudinal studies [19][20][21][22][23] (Table 1), but the results are inconsistent and controversial 17 . Although the diagnosis of KOA is often based on the combination of plain radiographs and subjective symptoms, several studies have described the involvement of psychological factors such as depression in the severity of symptoms and physical function in patients with KOA 24 . The need to consider psychological factors in assessing the association between KOA and falls has been addressed 13 , but we found no published investigation of the impact of radiographic KOA severity on fall risk that also takes into account psychological factors.…”

Osteoarthritis Depression Impacts and Possible Solutions Among Older Adults: Year 2021-2022 in Review

“…In addition, cohorts in some studies could not be readily classified as being older adults [65 years >] [eg., 3] or as well defined cases of either early or moderate osteoarthritis of any joint except the knee. Others examined samples of osteoarthritis cases alongside cases of inflammatory arthritis or other comorbid conditions associated with depression, or rendered conclusions based on pre-collected historical data [4], where deductions were made retrospectively or based on regression models of baseline data rather than actual observations [5]. Moreover, the joints studied and their diverse degrees of pathology within and across studies plus discrepant inclusion and exclusion criteria, along with differential modes of assessing osteoarthritis severity, as well as depressive symptom duration and severity, generally precluded any meaningful synthesis.…”