Global management of patients with knee osteoarthritis begins with quality of life assessment: a systematic review

Marianna Vitaloni, Angie Botto-van Bemden, Rosa Maya Sciortino Contreras, Deborah Scotton, Marco Bibas, Maritza Quintero, Jordi Monfort, Xavier Carné, Francisco de Abajo, Elizabeth Oswald, Maria R Cabot, Marco Matucci, Patrick du Souich, Ingrid Möller, Guy Eakin, Josep Verges, Marianna Vitaloni, Angie Botto-van Bemden, Rosa Maya Sciortino Contreras, Deborah Scotton, Marco Bibas, Maritza Quintero, Jordi Monfort, Xavier Carné, Francisco de Abajo, Elizabeth Oswald, Maria R Cabot, Marco Matucci, Patrick du Souich, Ingrid Möller, Guy Eakin, Josep Verges

Abstract

Background: Knee osteoarthritis (KOA) is a prevalent form of chronic joint disease associated with functional restrictions and pain. Activity limitations negatively impact social connectedness and psychological well-being, reducing the quality of life (QoL) of patients. The purpose of this review is to summarize the existing information on QoL in KOA patients and share the reported individual factors, which may influence it.

Methods: We conducted a systematic review examining the literature up to JAN/2017 available at MEDLINE, EMBASE, Cochrane, and PsycINFO using KOA and QOL related keywords. Inclusion criteria were QOL compared to at least one demographic factor (e.g., age, gender), lifestyle factor (e.g., functional independence), or comorbidity factor (e.g., diabetes, obesity) and a control group. Analytical methods were not considered as part of the original design.

Results: A total of 610 articles were reviewed, of which 62 met inclusion criteria. Instruments used to measure QoL included: SF-36, EQ-5D, KOOS, WHOQOL, HAS, AIMS, NHP and JKOM. All studies reported worse QoL in KOA patients when compared to a control group. When females were compared to males, females reported worse QOL. Obesity as well as lower level of physical activity were reported with lower QoL scores. Knee self-management programs delivered by healthcare professionals improved QoL in patients with KOA. Educational level and higher total mindfulness were reported to improve QoL whereas poverty, psychological distress, depression and lacking familial relationships reduce it. Surgical KOA interventions resulted in good to excellent outcomes generally; although, results varied by age, weight, and depression.

Conclusion: KOA has a substantial impact on QoL. In KOA patients, QoL is also influenced by specific individual factors including gender, body weight, physical activity, mental health, and education. Importantly, education and management programs designed to support KOA patients report improved QoL. QoL data is a valuable tool providing health care professionals with a better comprehension of KOA disease to aid implementation of the most effective management plan.

Keywords: Individual factors; Knee; Osteoarthritis; Patient Centred; Patient advocacy organizations; Psychosocial factors; Quality of life; Social Determinants of Health.

Conflict of interest statement

Dr. Möller declares to be a member of the editorial board of this journal.

Figures

Fig. 1
Fig. 1
Quality Appraisal tool. The quality appraisal tool is a modify version of the quality appraisal tool recommended by Cochrane. Three independent researchers scored the 13 items
Fig. 2
Fig. 2
Flowchart of study selection. A total of 9143 articles were initially identify, 610 articles were then selected based on title and abstract screening. 62 articles were included in the final study

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