Early onset osteoarthritis knee in premature menopausal women
Keywords:Osteoarthritis, Pain, Menopause, Awareness
Background: Women with early menopause medical (disease) or surgical (hysterectomy) are having postmenopausal symptoms after a variable period. Osteoarthritis (OA) strikes women more often than men and it increases in prevalence, incidence and severity after menopause. The present study was done to evaluate early onset osteoarthritis knee in premature (early) menopausal women.
Methods: We have studied 160 women with early menopause (before 40 yrs of age) developing symptoms and well established osteo arthritic knees. We have studied various factors with early menopause. The data was analysed using SPSS software version 22.
Results: In our study 138 cases (86.25%) were surgical menopause (hysterectomy) and 22 cases (13.75%) were medical menopause where definite cause was not obvious. An early onset knee pain was noted in 1 to 2 years. But late OA was noted after 6 to 7 years of menopause. Effective treatment was wanted by majority of the patient from the point of view of post-menopausal osteosaropaenia and physiotherophy. Even in urban population erratic treatment was maximum (75%). Dysfunctional uterine bleeding, fibroid or severe intractable infection appeared be the most common indication for hysterectomy.
Conclusions: We concluded that with better awareness of menopause, effective regular treatment and physiotherapy can herald the process of osteoarthritis. The difficulties were mainly developed early because of lack of awareness, no effective regular treatment and physiotherapy. Pain is the starting feature which may continue to severe disability later on.
Chopra A, Patil J, Bilampelly V. The bhigwan (India) COPCORD: Methodology and first information report. APLAR J Rheumatol. 1997;1:145-54.
Das SK, Ramakrishnan S. Osteoarthritis. In: Manual of Rheumatology. Pispati PK, Borges NE, Nadkar MY (eds). 2nd edition. Indian Rheumatology Association, The National Book Depot, Mumbai, India; 2002: 240-259.
Mahajan A, Tandon V, Verma S, Sharma S. Osteoarthritis and menopause. J Indian Rheumatol Assoc. 2005;13:21-5.
Prieto-Alhambra D, Judge A, Javaid MK, Cooper C, Diez-Perez A, Arden NK, et al. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: Influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis. 2014;73:1659–64.
Progretto Menopausa Italia Study Group, Parazzini F. Menopausal status, hormone replacement therapy use and risk of self-reported physician-diagnosed osteoarthritis in women attending menopause clinics in Italy. Maturitas. 2003;46:207–12.
Turner AS, Athanasiou KA, Zhu CF, Alvis MR, Bryant HU. Biochemical effects of estrogen on articular cartilage in ovariectomized sheep. Osteoarthritis Cartilage. 1997;5(1):63-9.
Tsai CL, Liu TK. Osteoarthritis in women: its relationship to estrogen and current trends. Life sciences. 1992;50(23):1739-44.
Rosner IA, Goldberg VM, Moskowitz RW. Estrogens and osteoarthritis. Clinical orthopaedics and related research. 1986;(213):77-83.
Schouten JS, Van Den Ouweland FA, Valkenburg HA. Natural menopause, oophorectomy, hysterectomy and the risk of osteoarthritis of the dip joints. Scandinavian journal of rheumatology. 1992;21(4):196-200.
Spector TD, Brown GC, Silman AJ. Increased rates of previous hysterectomy and gynaecological operations in women with osteoarthritis. British Med J. 1988;297(6653):899.
Jung JH, Bang CH, Song GG, Kim C, Kim JH, Choi SJ. Knee osteoarthritis and menopausal hormone therapy in postmenopausal women: a nationwide cross-sectional study. Menopause. 2019;26(6):598-602.
Ceskum L. Lack of association of reproductive and Gynaecological factors with radiographic features OA of knee in post menopausal women. Arthritis Rheum. 1995;38:5-223.
Barcenilla-Wong AL, Chen JS, March LM. Concern and risk perception: effects on osteoprotective behaviour. J Osteoporosis. 2014;2014:1-10.