Browse > Article
http://dx.doi.org/10.12674/ptk.2019.26.2.069

Evaluation of the Relationships Between Kellgren-Lawrence Radiographic Score and Knee Osteoarthritis-related Pain, Function, and Muscle Strength  

Kim, Si-hyun (Dept. of Physical Therapy, Sangi University)
Park, Kyue-nam (Dept. of Physical Therapy, College of Medical Science, Jeonju University)
Publication Information
Physical Therapy Korea / v.26, no.2, 2019 , pp. 69-75 More about this Journal
Abstract
Background: Knee osteoarthritis (OA) diagnosis using Kellgren-Lawrence scores is commonly used to help decision-making during assessment of the severity of OA with assessment of pain, function and muscle strength. The association between Kellgren-Lawrence scores and functional/clinical outcomes remains controversial in patients with knee OA. Objects: The purpose of this study was to examine the relationships between Kellgren-Lawrence scores and knee pain associated with OA, function during daily living and sports activities, quality of life, and knee muscle strength in patients with knee OA. Methods: We recruited 66 patients with tibiofemoral knee OA and determined knee joint Kellgren-Lawrence scores using standing anteroposterior radiographs. Self-reported knee pain, daily living function, sports/recreation function, and quality of life were measured using the knee injury and OA outcome score (KOOS). Knee extensors and flexors were assessed using a handheld dynamometer. We performed Spearman's rank correlation analyses to evaluate the relationships between Kellgren-Lawrence and KOOS scores or muscle strength. Results: Kellgren-Lawrence scores were significantly negatively correlated with KOOS scores for knee pain, daily living function, sports/recreation function, and quality of life. Statistically significant negative correlations were found between Kellgren-Lawrence scores and knee extensor strength but not flexor strength. Conclusion: Higher Kellgren-Lawrence scores were associated with more severe knee pain and lower levels of function in daily living and sports/recreation, quality of life, and knee extensor strength in patients with knee OA. Therefore, we conclude that knee OA assessment via self-reported KOOS and knee extensor strength may be a cost-effective alternative to radiological exams.
Keywords
Function; Knee; Osteoarthritis; Pain; Radiography;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29(8):1039-1049.   DOI
2 Baert IA, Staes F, Truijen S, et al. Weak associations between structural changes on MRI and symptoms, function and muscle strength in relation to knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2014;22(9):2013-2025. https://doi.org/10.1007/s00167-013-2434-y   DOI
3 Bedson J, Croft P. The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature. BMC Musculoskelet Disord. 2008;9:116. https://doi.org/10.1186/1471-2474-9-116   DOI
4 Creamer P, Lethbridge-Cejku M, Hochberg MC. Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology (Oxford). 2000;39(5):490-496.   DOI
5 Cubukcu D, Sarsan A, Alkan H. Relationships between pain, function and radiographic findings in osteoarthritis of the knee: A cross-sectional study. Arthritis. 2012;2012:984060. https://doi.org/10.1155/2012/984060   DOI
6 Culvenor AG, Engen CN, Oiestad BE, et al. Defining the presence of radiographic knee osteoarthritis: A comparison between the Kellgren and Lawrence system and OARSI atlas criteria. Knee Surg Sports Traumatol Arthrosc. 2015;23(12):3532-3539. https://doi.org/10.1007/s00167-014-3205-0   DOI
7 Ersoz M, Ergun S. Relationship between knee range of motion and Kellgren-Lawrence radiographic scores in knee osteoarthritis. Am J Phys Med Rehabil. 2003;82(2):110-115. https://doi.org/10.1097/01.PHM.0000046630.43199.A2   DOI
8 Farrokhi S, Chen YF, Piva SR et al. The influence of knee pain location on symptoms, functional status and knee-related quality of life in older adults with chronic knee pain: Data from the osteoarthritis initiative. Clin J Pain. 2016;32(6):463-470. https://doi.org/10.1097/AJP.0000000000000291   DOI
9 Goncalves GH, Sendin FA, da Silva Serrao PRM, et al. Ankle strength impairments associated with knee osteoarthritis. Clin Biomech (Bristol, Avon). 2017;46:33-39. https://doi.org/10.1016/j.clinbiomech.2017.05.002   DOI
10 Muff G, Dufour S, Meyer A, et al. Comparative assessment of knee extensor and flexor muscle strength measured using a hand-held vs. isokinetic dynamometer. J Phys Ther Sci. 2016;28(9):2445-2451. https://doi.org/10.1589/jpts.28.2445   DOI
11 Hannan MT, Felson DT, Pincus T. Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatol. 2000;27(6):1513-1517.
12 Henriksen M, Christensen R, Klokker L, et al. Evaluation of the benefit of corticosteroid injection before exercise therapy in patients with osteoarthritis of the knee: A randomized clinical trial. JAMA Intern Med. 2015;175(6):923-930. https://doi.org/10.1001/jamainternmed.2015.0461   DOI
13 Muraki S, Akune T, Teraguchi M et al. Quadriceps musclestrength, radiographic knee osteoarthritis and knee pain: The ROAD study. BMC Musculoskelet Disord. 2015;16:305. https://doi.org/10.1186/s12891-015-0737-5   DOI
14 Ho-Pham LT, Lai TQ, Mai LD, et al. Prevalence of radiographic osteoarthritis of the knee and its relationship to self-reported pain. PLoS One. 2014; 9(4):e94563. https://doi.org/10.1371/journal.pone.0094563   DOI
15 Kemnitz J, Wirth W, Eckstein F, et al. Longitudinal change in thigh muscle strength prior to and concurrent with symptomatic and radiographic knee osteoarthritis progression: Data from the osteoarthritis initiative. Osteoarthritis Cartilage. 2017;25(10):1633-1640. https://doi.org/10.1016/j.joca.2017.07.003   DOI
16 Kiadaliri AA, Lamm CJ, de Verdier MG, et al. Association of knee pain and different definitions of knee osteoarthritis with health-related quality of life: A population-based cohort study in southern Sweden. Health Qual Life Outcomes. 2016;14(1):121. https://doi.org/10.1186/s12955-016-0525-4   DOI
17 Koblbauer IF, Lambrecht Y, van der Hulst ML, et al. Reliability of maximal isometric knee strength testing with modified hand-held dynamometry in patients awaiting total knee arthroplasty: Useful in research and individual patient settings? A reliability study. BMC Musculoskelet Disord. 2011;12:249. https://doi.org/10.1186/1471-2474-12-249   DOI
18 Luc-Harkey BA, Safran-Norton CE, Mandl LA, et al. Associations among knee muscle strength, structural damage, and pain and mobility in individuals with osteoarthritis and symptomatic meniscal tear. BMC Musculoskelet Disord. 2018;19(1):258. https://doi.org/10.1186/s12891-018-2182-8   DOI
19 Neogi T, Felson D, Niu J, et al. Association between radiographic features of knee osteoarthritis and pain: Results from two cohort studies. BMJ. 2009;339:b2844. https://doi.org/10.1136/bmj.b2844   DOI
20 Oiestad BE, Holm I, Engebretsen L, et al. The association between radiographic knee osteoarthritis and knee symptoms, function and quality of life 10-15 years after anterior cruciate ligament reconstruction. Br J Sports Med. 2011;45(7):583-588. https://doi.org/10.1136/bjsm.2010.073130   DOI
21 Roos EM, Toksvig-Larsen S. Knee injury and osteoarthritis outcome score (KOOS)-validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes. 2003;1:17. https://doi.org/10.1186/1477-7525-1-17   DOI
22 Omori G, Koga Y, Tanaka M, et al. Quadriceps muscle strength and its relationship to radiographic knee osteoarthritis in Japanese elderly. J Orthop Sci. 2013;18(4):536-542. https://doi.org/10.1007/s00776-013-0383-4   DOI
23 Plotnikoff R, Karunamuni N, Lytvyak E, et al. Osteoarthritis prevalence and modifiable factors: A population study. BMC Public Health. 2015;15:1195. https://doi.org/10.1186/s12889-015-2529-0   DOI
24 Riddle DL, Jiranek WA. Knee osteoarthritis radiographic progression and associations with pain and function prior to knee arthroplasty: A multicenter comparative cohort study. Osteoarthritis Cartilage. 2015;23(3):391-396. https://doi.org/10.1016/j.joca.2014.12.013.   DOI
25 Segal NA, Torner JC, Felson D, et al. Effect of thigh strength on incident radiographic and symptomatic knee osteoarthritis in a longitudinal cohort. Arthritis Rheum. 2009;61(9):1210-1217. https://doi.org/10.1002/art.24541   DOI
26 Seo SS, Chung KC, Kim YB. Assessment of validity, reliability and responsiveness of korean knee injury and osteoarthritis outcome score (KOOS) for the knee injury. J Korean Orthop Assoc. 2006;41(3):441-453.   DOI
27 Zhai G, Blizzard L, Srikanth V, et al. Correlates of knee pain in older adults: Tasmanian older adult cohort study. Arthritis Rheum. 2006;55(2):264-271.   DOI
28 Tevald MA, Murray A, Luc BA, et al. Hip abductor strength in people with knee osteoarthritis: A cross-sectional study of reliability and association with function. Knee. 2016;23(1):57-62. https://doi.org/10.1016/j.knee.2015.06.006   DOI
29 Silverwood V, Blagojevic-Bucknall M, Jinks C, et al. Current evidence on risk factors for knee osteoarthritis in older adults: A systematic review and meta-analysis. Osteoarthritis Cartilage. 2015;23(4):507-515. https://doi.org/10.1016/j.joca   DOI