Severe Hand Osteoarthritis Strongly Correlates with Major Joint Involvement and Surgical Intervention

Abstract Introduction The presence of hand OA increases the risk for developing OA in other major joints. Although genetic predisposition has been implicated in its causation, its exact role has yet to be established. The association of hand OA with symptomatic and asymptomatic major joint(s) has not been previously studied. Material and Methods 100 consecutive patients had a hand photo taken for visual documentation of the hand joints. Radiographs of hand and all major symptomatic joint(s) were analyzed and classified using the Kellgren-Lawrence (KL) scale by two independent observers including an orthopaedic radiologist. Results Severe hand OA was present in 91% of the patients. Radiographic analysis showed the hip was involved in 88% of the patients, of whom 85.2% (75) were symptomatic and 14.7% (13) were asymptomatic. 62.5% (55) of symptomatic hip patients required hip replacement. Knee involvement was present in 37% of the patients and all were symptomatic and 81.1% (30) of these required knee replacement. 33% (28) had bilateral and 6% (5) had ‘two joint (hip&knee)’ surgery. Spine involvement was present in 72% of the patients. There was a significant correlation between hand radiographic findings of OA and hip (r=0.68;p=0.03), knee (r=0.58;p=0.042), and spine (r=0.39;p=0.05) involvement. Conclusions There was a significant correlation between severe hand OA and hip, knee and spine involvement. Severity of Hand OA can have a predictive value on multiple joint involvement and risk of surgical intervention. This study emphasizes the need to investigate the genetic predisposition in causation of OA.