title: The substantial personal burden experienced by younger people with hip or knee osteoarthritis.
abstract: OBJECTIVE
  To compare Health-Related Quality of Life (HRQoL) and psychological distress in younger people with hip or knee osteoarthritis (OA) to age- and sex-matched population norms, and evaluate work limitations in this group.
  
  
  METHODS
  People aged 20-55 years with hip or knee OA were recruited from major hospitals (n = 126) and community advertisements (n = 21). HRQoL was assessed using the Assessment of Quality of Life (AQoL) instrument (minimal important difference 0.06 AQoL units) and compared to population norms. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10) and the prevalence of high/very high distress (K10 score ≥22) was compared to Australian population data. Work limitations were evaluated using the Workplace Activity Limitations Scale (WALS).
  
  
  RESULTS
  Considering most participants had a relatively recent OA diagnosis (<5 years), the extent of HRQoL impairment was unexpected. A very large reduction in HRQoL was evident for the overall sample, compared with population norms (mean difference -0.35 AQoL units, 95% CI -0.40 to -0.31). Females, people aged 40-49 years, and those with hip OA reported average HRQoL impairment of almost 40% (mean reductions -0.38 to -0.39 AQoL units). The overall prevalence of high/very high distress was 4 times higher than for the population (relative risk 4.19, 95% CI 3.53-4.98) and 67% reported moderate to considerable OA-related work disability, according to WALS scores.
  
  
  CONCLUSIONS
  These results clearly demonstrate the substantial personal burden experienced by younger people with hip or knee OA, and support the provision of targeted services to improve HRQoL and maximise work participation in this group.
authors.affiliation: The University of Melbourne and Melbourne Health, Melbourne, Australia. Electronic address: i.ackerman@unimelb.edu.au.
authors.forename: I N
authors.initials: IN
authors.lastname: Ackerman
authors.affiliation: Melbourne Health, Melbourne, Australia. Electronic address: Andrew.Bucknill@mh.org.au.
authors.forename: A
authors.initials: A
authors.lastname: Bucknill
authors.affiliation: University Hospital Geelong and Deakin University, Geelong, Australia. Electronic address: richardpage@geelongortho.com.au.
authors.forename: R S
authors.initials: RS
authors.lastname: Page
authors.affiliation: Peninsula Health, Frankston, Australia. Electronic address: nigel.s.broughton@gmail.com.
authors.forename: N S
authors.initials: NS
authors.lastname: Broughton
authors.affiliation: Melbourne Health, Melbourne, Australia. Electronic address: Carol.Roberts@mh.org.au.
authors.forename: C
authors.initials: C
authors.lastname: Roberts
authors.affiliation: Melbourne Health, Melbourne, Australia. Electronic address: Bernarda.Cavka@mh.org.au.
authors.forename: B
authors.initials: B
authors.lastname: Cavka
authors.affiliation: University Hospital Geelong, Geelong, Australia. Electronic address: PETERSC@BarwonHealth.org.au.
authors.forename: P
authors.initials: P
authors.lastname: Schoch
authors.affiliation: Melbourne Health, Melbourne, Australia. Electronic address: caroline.brand@monash.edu.
authors.forename: C A
authors.initials: CA
authors.lastname: Brand
mesh_terms: D000328:Adult; D000367:Age Factors; D001315:Australia; D016022:Case-Control Studies; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000523:psychology*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000523:psychology*; D010147:Pain Measurement; D011788:Quality of Life; D012737:Sex Factors; D013315:Stress, Psychological / Q000209:etiology; D014937:Work; D055815:Young Adult
keywords: Health status; Osteoarthritis; Quality of life; Work limitations; Work participation