Determinants of pain and functioning in hip osteoarthritis – a two-year prospective study

Abstract

Objective:

To identify predictors of pain and disability in hip osteoarthritis.

Design:

A prospective analysis of determinants of pain and functioning in hip osteoarthritis.

Study setting:

Rehabilitation clinic in a central hospital.

Patients:

A total of 118 men and women aged 55–80 years who had radiologically diagnosed hip osteoarthritis and associated clinical symptoms and participated in a randomized controlled trial.

Main measures:

The self-reported disease-specific pain and physical function were assessed using the pain and functioning subscales of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index. The self-reported generic physical and mental functioning were assessed by using the Finnish-validated SF-36-item Health Survey RAND-36 subscales for function and physical and mental component summary scores. Outcome measures were recorded at 0, 3, 6, 12, 18 and 24 months.

Results:

Multivariate linear mixed model analyses revealed that lower disease-specific pain score and better functioning (WOMAC) were predicted by higher educational level (9.61 (3.15 to 16.07); 9.07 (2.05 to 16.09)), supervised exercise training (−10.13 (−17.87 to −2.39); −11.58 (−19.40 to −3.77)), habitual conditioning physical activity (−0.48 (−0.96 to −0.01); −0.39 (−0.84 to 0.05)), absence of comorbidities (−6.30 (−12.35 to −0.24); −7.87 (−14.45 to −1.30)) and absence of additional knee osteoarthritis (−7.62 (−13.87 to −1.36); −8.02 (−14.81 to −1.23)), respectively. The same factors, except for the comorbidities, also predicted general physical functioning score (RAND-36).

Conclusions:

Higher education, absence of knee osteoarthritis and comorbidities, supervised exercise training and habitual conditioning physical activity predicted a lower presence of pain and better functional status in patients with hip osteoarthritis.