Cross-Sectional Contrast Between Individuals With Foot/Ankle vs Knee Osteoarthritis for Obesity and Low Education on Health-Related Quality of Life.
BACKGROUND
Improving health-related quality of life (HRQoL) necessitates an understanding of the influence of patient characteristics on, and interrelationship among, HRQoL domains. In osteoarthritis (OA), these associations have predominantly been examined in hip/knee populations. We investigated whether there were differences in these associations between foot/ankle and knee OA samples.


METHODS
Individuals seeking orthopedic care for foot/ankle or knee OA completed a questionnaire pre-consultation, including HRQoL domains (bodily pain [BP], physical [PF] and social functioning [SF], and mental [MH] and general health [GH]), obesity, comorbidity, and sociodemographic characteristics. Associations were examined via stratified path analysis (foot/ankle vs knee). Foot/ankle: n = 180, mean age = 55 (range: 25 to 82), 52% female. Knee: n = 253, mean age = 62 (range: 26 to 92), 51% female.


RESULTS
The interrelationship among HRQoL domains was generally similar between groups. However, the influence of patient characteristics differed. Low educational status was associated with worse scores for GH, MH, and SF in the foot/ankle group, whereas no significant effects were found in the knee group. Obesity was associated with worse scores for SF, BP, and GH in the foot/ankle compared to the knee group. Patient characteristics explained considerably more of the variation in domain scores in the foot/ankle group.


CONCLUSIONS
There are significant differences in the impact of patient characteristics on HRQoL domains in foot/ankle versus knee OA patients. Therefore, a universal approach to patient education/intervention to improve HRQoL in lower-extremity OA is not likely to achieve optimal results. Based on these findings, we recommend joint-specific patient education, with a particular emphasis on patient characteristics among the foot/ankle OA population.


METHODS
Level III, retrospective comparative study.
Arthritis Program, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada perrucci@uhnres.utoronto.ca.
Anthony V
AV
Perruccio
Arthritis Program, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Rajiv
R
Gandhi
Arthritis Program, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Johnny T C
JT
Lau
Arthritis Program, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Khalid A
KA
Syed
Arthritis Program, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Nizar N
NN
Mahomed
Arthritis Program, Toronto Western Hospital and Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Y Raja
YR
Rampersaud
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000503:physiopathology*; D004522:Educational Status; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D010003:Osteoarthritis / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
ankle; education; foot; knee; obesity; osteoarthritis; pain; path analysis; quality of life; sociodemographic