Is self-reported improvement in osteoarthritis pain and disability reflected in objective measures?
OBJECTIVE
To determine if self-reported improvements in pain and function correlate with improvement in objective measures of disease in osteoarthritis (OA).


METHODS
Individuals with disabling hip/knee OA were assessed 7 years apart by questionnaire [sociodemographics, body mass index, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores] and physical [range of motion (ROM), disease activity based on joint stress pain, erythema, warmth, effusion] and radiographic examination of the hips and knees (Kellgren-Lawrence grade). Changes over time were expressed as improved, unchanged, or worse based on a priori criteria.


RESULTS
Of 69 eligible patients, 43 (64%) with a mean age of 76.3 years participated; 77% were female. For WOMAC scores, 25% and 19% reported improved pain and function, respectively. For joint ROM, disease activity, and radiographic grade, 0% to 30% of participants were improved. However, improvements in WOMAC scores were not associated with improvements in any of the other measures (r < 0.24 for all).


CONCLUSIONS
One-quarter of participants reported significant improvements in WOMAC pain and disability after 7 years' followup. However, these improvements were not associated with similar improvements in joint ROM, disease activity, or radiographic grade. Greater understanding of the determinants of self-reported improvements in arthritis status, in particular the role of adaptation, is warranted.
Johnson
Sindhu R
SR
Department of Health Policy, Management and Evaluation, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Archibald
Alison
A
Davis
Aileen M
AM
Badley
Elizabeth
E
Wright
James G
JG
Hawker
Gillian A
GA
D000203:Activities of Daily Living; D000368:Aged; D018771:Arthralgia / Q000209:etiology / Q000503:physiopathology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012649:Self Concept; D012720:Severity of Illness Index; D017211:Treatment Failure