Radiological Grading and the Functional Status of Primary Osteoarthritic Knee in Pre-Total Knee Replacement: A Cross-Sectional Study in Malaysia

This study aims to investigate the correlation of radiographic findings and the functional status of severe primary osteoarthritis (OA) knee in pre-total knee replacement (TKR) patients in Malaysia, a cohort representing the severe end of the OA spectrum This study included 100 patients with primary OA who were admitted for total arthroplasty. A cross-sectional study using the knee injury and Osteoarthritis Outcome Score (KOOS) and Kallgren-Lawrence (KL) classification (grading) was conducted at Tuanku Jaafar Hospital, Seremban, Malaysia. The sample size of 85 was calculated using the equation, N = [(Zα+Zβ)/C]2 + 3, and as for the comparison of a continuous variable, ANOVA was used whereby the statistical significance was set at p<0.05. Antero-posterior knee radiographs of the patients were graded according to Kellgren-Lawrence, and functional capacity was evaluated using KOOS. There was a total of 100 participants with 29 males and 71 females. Most patients were predominantly in the age group of 60-69 (42%) and 70-79 (46%) whereas the least was in the age group of 90-99 (1%). Patients interviewed were multiracial with Malay being 42%, Chinese being 32%, Indian being 25%, and 1% from other races. Characteristics of the patient do not contribute to the total KOOS outcome as all were p>0.05. There was statistical significance between KOOS and KL grading with p<0.001. There was also a correlation between KOOS and KL grading with a correlation coefficient, r of +0.373 showing that as KL grading increases, KOOS becomes worse. There is a significant, positive association between KOOS and KL grading which determines that higher radiographic severity with a higher KL grade is associated with worse functional status with a higher KOOS score.