Title: Prevalence and Risk Factors of Knee Osteoarthritis in a Rural Community of Odisha: A Snap Shot Study

Authors: Aswin Kumar Das, Dipanweeta Routray, Tapas Kumar Panigrahi

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.04

Abstract

Background: Osteoarthritis is a common disease of joint and the knee joint is mostly affected. The prevalence in India is 22-39%. Elder age group are more affected than younger age group. It affects female more than male. Knee OA is strongly associated with occupational activities that involves kneeling and squatting. Fruits, milk, meat, poultry are some protective dietary factors against knee OA. Paucity of community based surveys in Odisha, prompted authors to do a survey to find the prevalence and risk factors of knee OA in the rural community.

Materials and Methods:  A cross sectional survey was conducted across five villages during September 2017 to February 2018. 299 subjects were selected by multistage sampling. A questionnaire containing sociodemographic profile, diet, ACR criteria and possible risk factors was administered to the subjects after written consent. Then data was analysed using SPSS software version 16.0

Result: Prevalence of knee OA was found to be 29.7% [95% CI: 24.4% - 34.8%]. The associated risk factors are age ≥50years [p <0.001], female gender[p=<0.001], BMI more than 27.5 kg/m2[p=0.04], lower SES [p=0.03], activity involving kneeling or squatting [p=<0.001] etc. Regular fruit or vegetable consumption provide some protection against knee OA [OR=0.5; 0.3-0.9, p=0.02]. Farming as an occupation was found protective against knee OA [AOR=0.05; 0.009-0.301 P<0.001].

Conclusion: Every third person in this community is having knee OA. Risk factors are advancing age, female gender, and occupational activities involving kneeling and squatting, obesity. Farmers have some protection against knee OA.

Keywords: Knee Oteoarthritis, ACR criteria, Prevalence, Risk factors, Community study, Multistage sampling.

References

  1. Lian W, Liu H, Song Q, Liu YQ, Sun LY, Deng Q, Wang SP, Cao YH, Zhang XY, Jiang YY, Lv HY. Prevalence of hand osteoarthritis and knee osteoarthritis in Kashin-Beck disease endemic areas and non Kashin-Beck disease endemic areas: A status survey. PloS one. 2018 Jan 10;13[1]:e0190505.
  2. Radha MS, Gangadhar MR. Prevalence of knee osteoarthritis patients in Mysore city, Karnataka. Int J Recent Sci Res. 2015 Apr;6[4]:3316-20.
  3. Singh AK, KAlAivAni M, KriShnAn A, AggArwAl PK, Gupta SK. Prevalence of osteoarthritis of knee among elderly persons in urban slums using American College of Rheumatology [ACR] criteria. Journal of clinical and diagnostic research: JCDR. 2014 Sep;8[9]:JC09.
  4. Kaur R, Sharma VL, Singh A. Prevalence of Knee Osteoarthritis and its Correlation in Women of Rural and Urban Parts of Hoshiarpur [Punjab]. Journal of Postgraduate Medicine, Education and Research. 2015 Jan 1;49[1]:32.
  5. Pal CP, Singh P, Chaturvedi S, Pruthi KK, Vij A. Epidemiology of knee osteoarthritis in India and related factors. Indian journal of orthopaedics. 2016 Sep;50[5]:518.
  6. Plotnikoff R, Karunamuni N, Lytvyak E, Penfold C, Schopflocher D, Imayama I, Johnson ST, Raine K. Osteoarthritis prevalence and modifiable factors: a population study. BMC Public Health. 2015 Dec;15[1]:1195.
  7. Cho HJ, Morey V, Kang JY, Kim KW, Kim TK. Prevalence and risk factors of spine, shoulder, hand, hip, and knee osteoarthritis in community-dwelling Koreans older than age 65 years. Clinical Orthopaedics and Related Research®. 2015 Oct 1;473[10]:3307-14.
  8. Chopra A, Patil J, Billempelly V, Relwani J, Tandle HS. Prevalence of rheumatic diseases in a rural population in western India: a WHO-ILAR COPCORD Study. The Journal of the Association of Physicians of India. 2001 Feb;49:240-6.
  9. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, Howell D. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis & Rheumatology. 1986 Aug 1;29[8]:1039-49.
  10. Singh T, Sharma S, Nagesh S. Socio-economic status scales updated for 2017. International Journal of Research in Medical Sciences. 2017 Jun 24;5[7]:3264-7.
  11. Ajit NE, Nandish B, Fernandes RJ, Roga G, Kasthuri A, Shanbhag D, Goud BR. Prevalence of knee osteoarthritis in rural areas of Bangalore urban district. Internet Journal of Rheumatology and Clinical Immunology. 2014 Jan 6;1[S1].
  12. Hame SL, Alexander RA. Knee osteoarthritis in women. Current reviews in musculoskeletal medicine. 2013 Jun 1;6[2]:182-7.
  13. Souza IF, Oliveira Neta RS, Gazzola JM, Souza MC. Elderly with knee osteoarthritis should perform nutritional assessment: integrative literature review. Einstein [São Paulo]. 2017 Jun;15[2]:226-32.
  14. Sanghi D, Mishra A, Sharma AC, Raj S, Mishra R, Kumari R, Natu SM, Agarwal S, Srivastava RN. Elucidation of dietary risk factors in osteoarthritis knee—a case-control study. Journal of the American College of Nutrition. 2015 Jan 2;34[1]:15-20.
  15. Zhang Y, Zeng C, Wei J, Li H, Yang T, Yang Y, Deng ZH, Ding X, Lei G. Associations of cigarette smoking, betel quid chewing and alcohol consumption with high-sensitivity C-reactive protein in early radiographic knee osteoarthritis: a cross-sectional study. BMJ open. 2016 Mar 1;6[3]:e010763.
  16. Zhang Y, Zeng C, Li H, Yang T, Deng ZH, Yang Y, Ding X, Xie DX, Wang YL, Lei GH. Relationship between cigarette smoking and radiographic knee osteoarthritis in Chinese population: a cross-sectional study. Rheumatology international. 2015 Jul 1;35[7]:1211-7.
  17. Palmer KT. Occupational activities and osteoarthritis of the knee.British medical bulletin. 2012 Apr 26;102[1]:147-70.
  18. Holmberg S, Thelin A, Thelin N. Is there an increased risk of knee osteoarthritis among farmers? A population-based case–control study. International archives of occupational and environmental health. 2004 Jun 1;77[5]:345-50.
  19. Rossignol M, Leclerc A, Hilliquin P, Allaert FA, Rozenberg S, Valat JP, Avouac B, Coste P, Savarieau B, Fautrel B. Primary osteoarthritis and occupations: a national cross sectional survey of 10 412 symptomatic patients. Occupational and environmental medicine. 2003 Nov 1;60[11]:882-6.
  20. Zhang Y, Hunter DJ, Nevitt MC, Xu L, Niu J, Lui LY, Yu W, Aliabadi P, Felson DT. Association of squatting with increased prevalence of radiographic tibiofemoral knee osteoarthritis: the Beijing Osteoarthritis Study. Arthritis & Rheumatology. 2004 Apr 1;50[4]:1187-92.
  21. Escamilla RF, Fleisig GS, Zheng N, Barrentine SW, Wilk KE, Andrews JR. Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises. Medicine and science in sports and exercise. 1998 Apr;30[4]:556-69.

Corresponding Author

Dr Dipanweeta Routray

Dept of Community Medicine, SCBMCH, Cuttack, 753007 India

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