Comparison of Clinical Signs Associated with Lumbar Spine in Patients with Simultaneous Knee Osteoarthritis and Lumbar Spine Osteoarthritis before and after Knee Arthroplasty

Abstract

Background: Knee osteoarthritis and low back pain (LBP) are common and occur at the same time in elderly. The LBP in patients who are candidates for knee arthroplasty affect the outcome and prognosis after surgery. In this study, we investigated the LBP in patients with simultaneous osteoarthritis of the knee and lumbar spine after total knee arthroplasty. Methods: In this cross-sectional study, 41 candidates for knee arthroplasty suffering from LBP were included in the study. Demographic and VAS questionnaires for LBP and WOMAC questionnaire for knee pain and function were completed by patients before surgery. Patients are graded according to the JAS index. Patients were followed up for at least 6 months to2 years. Results: Of41 patients, The mean age of patients was64.3 years. The mean of preoperative VAS index was5.15, while postoperative had decreased to 4.34(P= 0.024). Of the total number of patients in preoperative evaluation, 24.4% were in low grade based on the JAS index, followed by moderate(41.5%) and severe(34.1%) grade. The greatest improvement in the VAS index was related to those who were in the mild and moderate grade before surgery. The mean preoperative WOMAC index was found to be 55.1, while it was postoperatively reduced to 42.9(P= 0.000). Postoperative WOMAC was found to be correlated with postoperative VAS(P = 0.004). Conclusion: In patients with mild to moderate LBP and knee osteoarthritis, their back pain would improve if they had knee arthroplasty. However, in patients with severe LBP and knee osteoarthritis, the spine should be examined further.

Keywords

• Knee osteoarthritis
• back pain
• knee arthroplasty