Osteoarthritis in women reporting to tertiary care hospital in Eastern India: Associated factors determining management.

ABSTRACT

INTRODUCTION: Osteoarthritis (OA) is a painful joint condition that is left heavily underdiagnosed, as it is also related to advancing age. Hence, those affected, tend to live with it, until the condition becomes excruciating or disabling. The women in our society are a section, who have very poor health seeking behavior. However, in today's era, tertiary care hospitals offer definitive management for OA in the form of Joint Replacement Surgery (JRS). This again is taken up often as a last resort and is heavily dependent on the socioeconomic condition of the family. The surgery offers proven better quality of life. OBJECTIVES: This study discusses a public health hypothesis regarding the disease presentations of OA in women visiting a tertiary care hospital and endeavors to develop a model based on some predictors that increase the predilection of recommendation of surgery among these women, These studies have been done for general populations, but here we chose to study women, as the society in eastern part of the country is male dominated and the decision to go for a surgery in case of the women is dependent on several issues. This model perhaps will bring to light the need of surgery in the women with OA and help take some policy decisions to offer some subsidized care to this section of the society. The results were derived from 350 women coming to an orthopedic tertiary care center during a 6-month study period with joint pain in any of the big joints and then finally given a definitive diagnosis of OA based on radiological KL score and clinical presentations. RESULTS: Women above age 40 years were taken up; mean age in study being 55.94 SD 6.648 (maximum 83, minimum 43). A semi structured questionnaire was used to compare the sociodemographic parameters like type of residence, type of family, attained menopause, occupation, duration of OA, etc., In the sample, which gave multiple responses, right and left knee were maximally inflicted by OA i.e. 59.1% and 57.1% of cases, followed by hip (28.9%) and lower back (26.1%). 75% were offered conservative treatment, only 24.6% were on physiotherapy. CONCLUSION: Menopause, increased age, comorbidities, and preobese were seen to be significantly associated with recommendations of JRS. This can help develop a screening method for women and encourage them to undergo assessment for OA as a targeted intervention and address this growing burden of disease at the earliest.