Females with Knee Osteoarthritis have Greater Pain and Reduced Physical Function but Similar Radiological Grading at Presentation: A Cross-sectional Observational Study.

Background: This study aims to assess the gender differences in clinical severity, physical function, and radiographic parameters in patients with knee osteoarthritis at presentation to a tertiary care center.

Materials and methods: We performed a cross-sectional observational study on patients with knee osteoarthritis aged more than 50 years who presented to a tertiary care center. Clinical assessment was done by modified WOMAC score. Physical function assessment was done by five performance-based tests: a thirty-second chair stand test, 40 m (4 × 10 m) fast-paced walk test, stair climb test, timed up-and-go test, and six-minute walk test. Radiographic assessment was done by plain radiographs using the Kellgren and Lawrence (KL) grading and measuring the femorotibial angle.

Results: A total of 111 patients (50 males and 61 females) were included. Females had significantly more pain and stiffness than males as assessed by modified WOMAC score at the time of presentation (pain: males 5.28 ± 3.0, females 7.45 ± 3.93, p-value 0.002) (stiffness: males 1.16 ± .81, females 1.63 ± .94, p-value 0.006). There was a statistically significant difference in all five performance-based physical function tests between the male and female patients (p-value < .05) with females showing poorer scores at the time of presentation. There was no statistically significant difference in the KL grading between males and females.

Conclusion: This study highlights significant gender differences in the clinical presentation of knee OA, with females experiencing greater pain, stiffness, and reduced physical functions but similar radiological grading at presentation. These findings emphasize the importance of comprehensive clinical assessment that must include both radiographic and physical function evaluation to ensure optimal management and improved outcomes for patients with knee OA.