The quality of life of postmenopausal women with hip and knee advanced dysfunction due to osteoarthritis prior to joint replacement

Authors

  • Iwona Morawik Department of Orthopaedics and Rehabilitation, Autonomous Public Teaching Hospital No. 4 in Lublin Author
  • Alina Jurewicz Department of Orthopedics and Traumatology, Autonomous Public Teaching Hospital No 1 Pomeranian Medical University Author
  • Marian Jędrych Department of Mathematics and Medical Biostatistics, Medical University of Lublin Author
  • Mirosław Jabłoński Department of Orthopaedics and Rehabilitation, Autonomous Public Teaching Hospital No. 4 in Lublin Author

Keywords:

osteoarthritis, hip, knee, menopause, quality of life

Abstract

Introduction. Surgical replacement of hip and knee joints with advanced degenerative and deformative changes is a method commonly used for treatment of such important and frequent ailments of the locomotor organ. In accordance with an obligatory system of scheduling in Poland the waiting time for a hip or knee endoprothesoplasty takes up to two years.

Aim. The aim of the research was to characterize and assess the quality of life of postmenopausal patients with the degenerative changes of hip joints (coxsarthrosis) and knee joints (gonarthrosis) waiting for joint arthroplasty.

Material and methods. The research was based on two groups of postmenopausal women aged 50-62 with advanced osteoarthritis of the hip (n=59) and knee (n=51). The quality of life just prior to the planned surgery was measured by means of an individually prepared survey where two questions from the HRQ Johansson and co. survey (1992) were used. In the statistical analysis with the significance of p<0.05 statistical hypotheses were verified with the use of U Mann-Whitney non-parametric test and Chi2 Pearson’s test as well as Fisher’s exact test.

Results. Advanced degenerative osteoarthritis of the knee more frequently than of the hip was related to overweight or obesity (p=0.02). In contrast to gonarthrosis, degenerative hip disease more often made foot care difficult (p=0.0002). The state of mind and individual health-esteem of patients with coxarthrosis compared with the same period a year before was significantly lower than of the patients with gonarthrosis (p=0.05). Due to lengthy time of symptoms the patients with hip dysfunction decided on operation faster (p<0.0001). Gonarthrosis occurred more frequently in a city, while patients from rural environment were more susceptible to hip diseases (p=0.04). Advanced coxarthrosis more often than gonarthrosis was related in investigated groups of postmenopausal females to elementary and vocational education rather than higher and post-vocational (p=0.05).

Conclusions. Coxarthrosis demands more rapid surgery than gonarthosis in comparable postmenopausal women. Coexistence of overweight and obesity related to gonarthrosis indicates a possibility, need and full medical justification for a body mass reduction in these very patients.

References

1. Bijlsma JWJ, Berenbaum F, Lafeber FPJG. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377:2115-26.

2. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham osteoarthritis study. Arthritis Rheum. 1987;30:914-8.

3. http://www.njrcentre.org.uk/njrcentre/Patients/Jointreplacementstatistics/ tabid/99/Default.aspx

4. http://www.surgery.com/procedure/hip-replacement-surgery/demographics

5. Jóźwiak M. Filogenetyczne i ontogenetyczne uwarunkowania chodu. In: W. Marciniak, A. Szulc (ed). Wiktora Degi Ortopedia i rehabilitacja. Warszawa: PZWL;2003. s. 27-38.

6. Dega W. Chód i jego mechanizm. Ortopedia i Rehabilitacja. Warszawa: PZWL; 1964. p.46-53.

7. Czubak J, Kruczyński J. Rozwojowa dysplazja i zwichnięcie stawu biodrowego. In: W. Marciniak, A. Szulc (red). Ortopedia i rehabilitacja. Warszawa: PZWL; 2003. s. 159-93.

8. Bourne R, Mukhi S, Zhu N, et al. Role of obesity on the risk for total hip or knee arthroplasty. Clin Orthop Relat Res. 2007;465:185-8.

9. Cooper C, Snow S, McAlindon TE, Kellingray S, Stuart B, Coggon D, Dieppe PA. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000;43:995-1000.

10. Salaffi F, Carotii M, Stancati A, Grassi W. Health-related quality of life in older adults with matched healthy controls. Aging Clin Exp Res. 2005;17:255-63.

11. [http://www.amd3.org/ROblog/2008/01/total-joint-replacement-educat- 2.html

12. Johanson NA, Charlson ME, Szatkowski TP, Ranawat CS. A Self- Administered Hip-Rating Questionnaire for the assesment of outcome after total hip replacement. J Bone Joint Surg. 1992;74-A(4):587-96.

13. Armitage P. Metody statystyczne w badaniach medycznych. Warszawa: PZWL; 1978.

14. Sawicki F. Elementy statystyki dla lekarzy. Warszawa: PZWL; 1982.

15. Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman BN, Aliabadi P, Levy D. The incidence and natural history of knee osteoarthritis in the elderly. The Framingham osteoarthritis study. Arthritis Rheum. 1995;38:1500-5.

16. Pawłowska H, Dmitruk A, Czeczuk A. Częstość występowania nadwagi i otyłości u dziewcząt i chłopców wiejskich w zależności od wykształcenia rodziców. Zdr Publ.2007;117:54-8.

17. Sygit K. Nieprawidłowości żywieniowe zagrożeniem zdrowia populacji dzieci i młodzieży. Zdr Publ. 2010;120:132-5.

18. Puenpatom RA, Victor TW. Increased prevalence of metabolic syndrome In individuals with osteoarthritis: an analysis of NHANES III data. Postgrad Med. 2009;121:9-20.

19. Nishimura A, Hasegawa M, Kato K, Hamada T, Uchida A, Sudo A. Risk factors for the incidence and progression of radiographic osteoarthritis of the knee among Japanese. Int Orthop. 2011;53:839-43.

20. Sudo A, Miyamoto N, Horikawa K, Urawa M, Yamakawa T, Hamada T, Uchida A. Prevalence and pisk factors for knee osteoarthritis in erderly Japanese men and women. J Ortop Sci. 2008;13:413-8.

21. Górajek-Jóźwik J. Filozofia i teorie pielęgniarstwa. Lublin: Czelej; 2007. p. 46-8.

22. Wang Y, Simpson JA, Wluka AE, Teichtah DR, Englisch DR, Giles GG, Graves S, Cicuttini FM. Relationship between body adipositiy measures and risk of primary knee and hip replacement for osteoarthritis: a prospective cohort study. Arthitis Res Ther. 2009;11:R31.

Downloads

Published

2012-04-01