Background knee osteoarthritis is a frequent matter of consultation in both general practice and rheumatology. Pain is the main symptom leading to a consultation. This painful experience can be influenced by various factors such as the anxio-depressive state or catastrophizing. Catastrophizing is known to be associated with lower analgesia results in total knee arthroplasty (1).
Objectives The aim of this study is to evaluate the correlation between the functional status (assessed by the Lequesne score) and the catastrophizing (assessed by the Sullivan score) in patient with osteoarthritis of the knee.
Methods We included patients consulting for knee osteoarthritis, meeting the OARSI criteria (2), one of the three general practitioners participating in the study or a rheumatologist at University Hospital. We excluded those with surgical indication. For each patient we registered the epidemiological data, the radiographic stage as well as the scores of Lequesne and Sullivan questionnaires. The correlation between the different scores were assessed with a Spearman test.
Results A total of 100 patients were included, 50 consulting a general practitioner and 50 consulting a rheumatologist, between November 2015 and April 2016. Among these 100 patients, there were mainly women (57%) with a mean age of 64.8±1.17 years old. The mean radiographic stage was 2.66±0.11 on the Kellgren and Lawrence scale. The Mean Sullivan score was 12.98±1.18 and the mean Lequesne score was 10.46±0.47. There was a close correlation (r=0.3, p=0.006) between the Lequesne score and the radiographic scale. There was no correlation between the Sullivan score and the radiographic scale. Howerver, the correlation between the Sullivan and the Lequesne scores was modest (r=0.47; p<0.0001) (Figure 1). Thus, the Lequesne score is correlated with the radiographic scale and the Sullivan score. When we compare the two populations, it appeared that the people consulting a rheumatologist are majority of women (72%) and younger (62.58±1.8 VS 67, 18±1.38 years, p<0.05) and with a shorter duration of symptoms (6.02±1.12 VS 12.96±1.5 Years, p<0.001). In terms of radiographic and functional impairment, the two populations were similar (Kellgren score of 2.59±0.15 VS 2.7±0.158 and Lequesne score of 11.13±0.67 VS 9.78±0,66. p>0.05) but there was a clear difference for the Sullivan score (16.96±1.67 VS 9±1.4; p<0.001).
Conclusions Our study is the first to highlight a correlation between the Sullivan and the Lequesne scores in patient consulting for osteoarthritis of the knee. Moreover, unlike the Sullivan, score the Lequesne score is correlated with the radiographic scale. The strength of this study is the inclusion of both patients consulting the general practitioner and those consulting the rheumatologist to avoid a recruitment bias. Indeed, patients consulting the rheumatologist had a catastrophizing score more important for the same functional and radiological impairment than those consulting the general practitioner. Thus, our population is representative of the global population suffering from osteoarthritis of the knee in terms of age, sex-ratio, BMI.The Lequesne score is a global score correlated with structural damage and with psychological factors like catastrophizing.
Disclosure of Interest None declared