Hana Sahli, Aicha Ben Tekaya, Selim Daas, Ines Mahmoud, Rawdha Tekaya
Department of Rheumatology, Mohamed Tahar Maamouri Hospital, Nabeul, Tunisia.
Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia.
Curr Rheumatol Rev. 2018;14(2):181-187. doi: 10.2174/1573397113666170425150133.
Knee osteoarthritis is a common pathology, characterized by a prevalence that increases with age. Absence of anatomo-clinical correlation is a complex management, particularly in a geriatric setting where it is not well studied.
The aim of the present study is to investigate the epidemio-clinical profile, functional impairment and radiographic features of knee osteoarthritis in the old patients versus younger patients (<65 years).
Cross-sectional study includes patients who were monitored for 6 months at a rheumatology department for knee osteoarthritis. Epidemio-clinical, anthropometric and radiographic data were gathered. A comparison was made of these various characteristics between patients of over 65 years of age (group1; n=56) and those under 65 (group2; n=56).
The mean age of the group 1 patients was 71±5 with a clear feminine predominance. Comorbidity was observed in two thirds of cases. More than half of them were overweight. Gonalgia had been evolving for approximately 8.4±9.2 years and was bilateral in 82.6% of the cases and of mechanical type in 94.6% of the cases. The patients experienced an average pain scale of 65.2mm. Pain had an anterior site in major of cases. An axial deviation of the lower limbs were observed in 60.7% of the cases and a limited mobility of the knees in 48.2% of the cases. The mean value of Lequesne index was 11.02±4.8. The walking distance was not limited in 37.5% of the cases. Radiographically, knee osteoarthritis was bilateral in all cases and stage 4 was observed in 50% of the cases. Comparative study showed that elderly patients had a smaller waist size (p=0.003), a longer course of gonalgia (p<0.0001), a widespread site of pain (p=0.004), and a more frequent limitation of walking distance (p<0.0001) as well as more axial deviation (p<0.0001) and joint mobility limitation (p=0.005). Gonalgia manifesting during rest was more frequent in elderly patients (p=0.001). In addition, impaired functioning (p=0.001) and the stage of radiographic damage (p=0.02) were more advanced in elderly patients.
The present study shows that knee osteoarthritis is more severe in the elderly patients in terms of clinical presentation and functional impairment.
膝关节骨关节炎是一种常见病症，其患病率随年龄增长而增加。解剖学与临床缺乏相关性是一种复杂的情况，尤其是在老年人群体中，对此研究尚不充分。
本研究旨在调查老年患者与年轻患者（<65岁）膝关节骨关节炎的流行病学临床特征、功能障碍和影像学特征。
横断面研究纳入了在风湿病科接受膝关节骨关节炎监测6个月的患者。收集了流行病学临床、人体测量和影像学数据。对65岁以上患者（第1组；n = 56）和65岁以下患者（第2组；n = 56）的这些不同特征进行了比较。
第1组患者的平均年龄为71±5岁，女性占明显优势。三分之二的病例存在合并症。其中一半以上超重。膝痛病程约为8.4±9.2年，82.6%的病例为双侧疼痛，94.6%的病例为机械性疼痛。患者的平均疼痛评分为65.2mm。大多数病例疼痛位于前方。60.7%的病例观察到下肢轴向偏差，48.2%的病例膝关节活动受限。Lequesne指数的平均值为11.02±4.8。37.5%的病例步行距离不受限。影像学检查显示，所有病例膝关节骨关节炎均为双侧，50%的病例为4期。比较研究表明，老年患者腰围较小（p = 0.003），膝痛病程较长（p < 0.0001），疼痛部位广泛（p = 0.004），步行距离受限更频繁（p < 0.0001），轴向偏差更多（p < 0.0001），关节活动受限更明显（p = 0.005）。老年患者静息时出现膝痛更为频繁（p = 0.001）。此外，老年患者的功能受损（p = 0.001）和影像学损伤阶段（p = 0.02）更严重。
本研究表明，膝关节骨关节炎在老年患者中的临床表现和功能障碍更为严重。
