Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis

Charles L Saltzman; M Bridget Zimmerman; Michael O'Rourke; Thomas D Brown; Joseph A Buckwalter; Richard Johnston

doi:10.2106/jbjs.f.00295

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Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis

Journal article

Peer reviewed

Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis

Charles L Saltzman, M Bridget Zimmerman, Michael O'Rourke, Thomas D Brown, Joseph A Buckwalter and Richard Johnston

Journal of bone and joint surgery. American volume, Vol.88(11), pp.2366-2372

11/2006

DOI: 10.2106/jbjs.f.00295

PMID: 17079392

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Abstract

Investigators seeking to understand the impact of musculoskeletal disorders commonly use validated outcome instruments to assess the effect of diseases on physical function and quality of life. However, the influence of concomitant systemic or musculoskeletal comorbidities on these scores has not been widely considered in orthopaedic research. The purpose of this study was to determine how morbidity unrelated to the ankle influences the perception of physical function and pain by patients with ankle osteoarthritis. Short Form-36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, Ankle Osteoarthritis Scale (AOS) pain scale scores, demographic data, and systemic and musculoskeletal comorbidities were determined prospectively for 195 patients with ankle osteoarthritis and ninety-five age and gender-matched controls. The effect of systemic and musculoskeletal comorbidities on each of the scores was determined. On the average, patients with ankle osteoarthritis had a relatively normal MCS score (47 +/- 13 points) and a markedly diminished PCS score (32 +/- 8 points). Both of these scores averaged 50 +/- 9 points in the control group. The AOS pain score averaged 61 +/- 23 points in the group with ankle osteoarthritis, whereas it averaged 10 +/- 15 points in the control group. We found the perception of ankle pain by patients with ankle osteoarthritis to be significantly and linearly associated with the number of other musculoskeletal problems (not related to the foot or ankle). The degree of physical impairment associated with ankle osteoarthritis, as measured with the SF-36, is equivalent to that reported to be associated with severely disabling medical problems including end-stage kidney disease and congestive heart failure. The perception of ankle health status as measured with a validated, patient-oriented, anatomically specific instrument is influenced by the patients' perception of their overall musculoskeletal comorbidity status. The authors of clinical studies using these instruments should adjust for concomitant musculoskeletal disease.

Ankle Joint

Prospective Studies

Pain - physiopathology

Humans

Middle Aged

Quality of Life

Female

Male

Surveys and Questionnaires

Health Status

Osteoarthritis - physiopathology

Osteoarthritis - complications

Details

Title: Subtitle: Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis
Creators: Charles L Saltzman - Department of Orthopaedics, University of Utah, 590 Wakara Drive, Salt Lake City, UT 84108, USA. charles.saltzman@hsc.utah.edu
M Bridget Zimmerman
Michael O'Rourke
Thomas D Brown
Joseph A Buckwalter
Richard Johnston
Resource Type: Journal article
Publication Details: Journal of bone and joint surgery. American volume, Vol.88(11), pp.2366-2372
DOI: 10.2106/jbjs.f.00295
PMID: 17079392
NLM abbreviation: J Bone Joint Surg Am
ISSN: 0021-9355
eISSN: 1535-1386
Publisher: Journal of Bone and Joint Surgery Incorporated; United States
Grant note: P50 AR48939 / NIAMS NIH HHS
Language: English
Date published: 11/2006
Academic Unit: Stead Family Department of Pediatrics; Biostatistics; Orthopedics and Rehabilitation; Injury Prevention Research Center
Record Identifier: 9983997330202771

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