Disability and quality of life of patients with knee or hip osteoarthritis in the primary care setting and factors associated with general practitioners' indication for prosthetic replacement within 1 year

Objective: To assess disability and health-related quality of life (HRQoL) of patients with knee or hip OA in primary care and to determine factors associated with GPs' opinion that their patients will need prosthetic replacement within 1 year after the consultation. Methods: Design: A cross-sectional national survey. Setting: Primary care in France. Participants: 1471 GPs and 4183 patients with hip or knee OA. Measures: Pain on an 11-point numeric scale (0-10), disability on the Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) (1-100) and Lequesne index (0-24), and quality of life on the Medical Outcomes Study 36-item Short Form (MOS SF-36; 0-100). Results: We analyzed records of 4121 patients (2540 knee, 1581 hip OA). Patients with knee or hip OA exhibited high and similar levels of pain (5.2 +/- 2.1 and 5.3 +/- 2.3) and disability (Lequesne score: 12.0 +/- 4.2 and 11.8 +/- 4.3; WOMAC score: 45.7 +/- 19.3 and 45.2 +/- 17.3) The decrease in HRQoL was similar for patients with either location of the disease. GPs more often considered that their patients with hip CA would need prosthetic replacement within 1 year (28.1%) than those with knee CA (15.8%). Most factors associated with GPs' opinion were identified for both locations of disease and were related to disability and pain levels. Conclusions: In the primary care setting, patients with knee or hip CA have similar, high disability levels and substantially low HRQoL. Patients' disability seems to play a central role in GPs' opinion of the need for their patients with either type of CA to undergo prosthetic replacement within 1 year. (C) 2008 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.