Physical functioning in patients with end-stage knee osteoarthritis: A cross-sectional study in Jordan using self-reported questionnaire and performance-based tests.

BACKGROUND: Knee osteoarthritis (OA) is a debilitating condition that leads to functional limitations. Self-reported questionnaires and performance-based tests are tools commonly used for measuring physical function. OBJECTIVES: (1) To evaluate the impact of end-stage knee OA on functional outcomes and examine the association between self-reported and performance-based measures of function in patients with end-stage knee osteoarthritis awaiting total knee arthroplasty (2) To explore the interrelationships among pain, strength, and overall physical function in this patient population. METHODS: In this cross-sectional analysis, 33 patients with end-stage knee OA were recruited and completed the knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and executed performance-based tests including the Timed Up and Go, the 30-second chair stand test, and the Stair Climbing Test. Knee pain, and isometric hip and knee strength were evaluated. RESULTS: Patients perceived deficits in their physical functionwith a score of 35/100 on the KOS-ADLS and demonstrated functional limitations in all performed tasks. KOS-ADLs was weakly associated with TUG and 30s-CST (r=-0.301, p= 0.047, and r= 0.39, p= 0.014. respectively). Knee pain was linked with the KOS-ADL score and GRS score (r=-0.406, p= 0.010; r=-0.343, p= 0.027; respectively), while the strength of the affected side was correlated with the performed (p=< 0.001) and reported function outcomes (p= 0.007). CONCLUSION: Participants exhibit declines in both perceived and executed functional abilities. Self-reported and performance-based functional measures are weakly correlated within our study group, highlighting the importance of incorporating both measures in clinical practice for a comprehensive evaluation of physical function. Pain was linked to subjective aspect of physical function, while strength was connected to perceived and performed functional capacity. Implementing a tailored rehabilitation program targeting muscle weakness and pain holds the potential to mitigate functional decline in individuals awaiting total knee arthroplasty (TKA).

Impact of end-stage knee osteoarthritis on perceived physical function and quality of life: A descriptive study from Jordan.

OBJECTIVE: Of the present study was to evaluate the impact of end-stage knee OA on patient's perception of their functional abilities and quality of life (QoL) using the self-reported questionnaire; the Knee Injury and Osteoarthritis Outcome Score (KOOS), and to determine the contribution of knee pain on patient's perceived outcomes. METHODS: Patients with end-stage knee OA who are on the waiting list for total knee arthroplasty were recruited in this cross-sectional study. Patients were asked to fill out the KOOS questionnaire. Knee pain for both sides was quantified on a continuous scale from 0-10. Age, and anthropometric data were recorded. Descriptive statistics were calculated for patients' characteristics, and for the scores of each KOOS subscale. Hierarchical linear regression models were created to determine the contributions of knee pain on two KOOS subscales; the function in daily living (KOOS-ADL), and the knee-related quality of life (KOOS-QoL). RESULTS: Patients in this study scored low across KOOS subscales (27.7% - 54.2%) with the QoL subscale being the lowest. After accounting for age and BMI, hierarchical linear regressions revealed that knee pain in both sides were determinants of self-perceived KOOS-ADLs, while only knee pain in the most-affected side significantly contributed to lower KOOS-QOL scores. CONCLUSION: End-stage knee OA negatively impact the patients' perceived function and quality of life. Patients' KOOS scores were similar to those reported in other countries, with QoL being the domain most affected. Our findings demonstrate that the level of knee pain has a determinant effect on our patients' perceptions of functional abilities and QoL. As waiting-list patients, addressing knee pain with a targeted regimen prior to TKA, as well as increasing patient's awareness about knee pain management, may improve/ or minimize deterioration in perceived functional ability and QoL while awaiting TKA.

A new technique of hindfoot reconstruction in chronic calcaneal osteomyelitis using the Ilizarov apparatus - a case series.

Calcaneal osteomyelitis (OM) is a challenging disease. Traditional surgical management has a limited success in preservation of the foot. The surgery proposed with the use of the Ilizarov apparatus for calcaneal OM aims to preserve the function, shape, and stability of the foot. Five patients between the age of 21 and 36 years, with isolated total and subtotal calcaneal OM, were treated with this technique in Royal Jordanian Medical Services (RJMS) institutions. Complex treatment included two stages: 1) radical sequestrectomy, and fixation of the foot in a favourable position with the Ilizarov fixator; 2) arthrodesis, reconstruction of the foot in order to fill in the bone defect. The patients were followed-up in the immediate (one month) and long-term (from one to six years) periods after treatment. The infection process was arrested and no recurrence was encountered. Weight-bearing ability was recovered. The shape of the hind foot was maximally close to natural. The patients reported high satisfaction.