Ratan Rajesh, Basak Manojit, Pal Dharm, Dwivedi Manish, Haq Rehan Ul
All India Institute of Medical Sciences Bhopal, Bhopal, India.
Indian J Orthop. 2025 Apr 15;59(4):549-557. doi: 10.1007/s43465-025-01365-x. eCollection 2025 Apr.
This study aims to assess the gender differences in clinical severity, physical function, and radiographic parameters in patients with knee osteoarthritis at presentation to a tertiary care center.
We performed a cross-sectional observational study on patients with knee osteoarthritis aged more than 50 years who presented to a tertiary care center. Clinical assessment was done by modified WOMAC score. Physical function assessment was done by five performance-based tests: a thirty-second chair stand test, 40 m (4 × 10 m) fast-paced walk test, stair climb test, timed up-and-go test, and six-minute walk test. Radiographic assessment was done by plain radiographs using the Kellgren and Lawrence (KL) grading and measuring the femorotibial angle.
A total of 111 patients (50 males and 61 females) were included. Females had significantly more pain and stiffness than males as assessed by modified WOMAC score at the time of presentation (pain: males 5.28 ± 3.0, females 7.45 ± 3.93, -value 0.002) (stiffness: males 1.16 ± .81, females 1.63 ± .94, -value 0.006). There was a statistically significant difference in all five performance-based physical function tests between the male and female patients (-value < .05) with females showing poorer scores at the time of presentation. There was no statistically significant difference in the KL grading between males and females.
This study highlights significant gender differences in the clinical presentation of knee OA, with females experiencing greater pain, stiffness, and reduced physical functions but similar radiological grading at presentation. These findings emphasize the importance of comprehensive clinical assessment that must include both radiographic and physical function evaluation to ensure optimal management and improved outcomes for patients with knee OA.
本研究旨在评估在三级医疗中心就诊的膝骨关节炎患者在临床严重程度、身体功能和影像学参数方面的性别差异。
我们对就诊于三级医疗中心的50岁以上膝骨关节炎患者进行了一项横断面观察性研究。临床评估采用改良WOMAC评分。身体功能评估通过五项基于表现的测试进行：30秒坐立试验、40米（4×10米）快步行走试验、爬楼梯试验、定时起立行走试验和6分钟步行试验。影像学评估通过使用Kellgren和Lawrence（KL）分级的普通X线片并测量股胫角进行。
共纳入111例患者（50例男性和61例女性）。就诊时，通过改良WOMAC评分评估，女性的疼痛和僵硬程度明显高于男性（疼痛：男性5.28±3.0，女性7.45±3.93，P值0.002）（僵硬：男性1.16±0.81，女性1.63±0.94，P值0.006）。在所有五项基于表现的身体功能测试中，男性和女性患者之间存在统计学显著差异（P值<0.05），女性在就诊时得分较低。男性和女性在KL分级上没有统计学显著差异。
本研究突出了膝骨关节炎临床表现中显著的性别差异，女性经历更严重的疼痛、僵硬和身体功能下降，但就诊时影像学分级相似。这些发现强调了全面临床评估的重要性，其中必须包括影像学和身体功能评估，以确保对膝骨关节炎患者进行最佳管理并改善预后。
