Knee, Knee Acute and Chronic Pain, Knee Arthritis Osteoarthritis, Knee Arthropathy, Knee Cartilage Defects, Knee Cartilage Lesions, Knee Osteoarthritis, Lipedema
Conditions
Keywords
lipedema, knee osteoarthritis, knee joint, knee
Brief summary
This study will be one of the few to examine the effect of lipedema on knee osteoarthritis in a comparative manner with a control group within the same osteoarthritis context. Although the relationship between obesity and osteoarthritis has been extensively studied in the literature, the effect of specific adipose tissue pathologies, such as lipedema, on osteoarthritis has not been sufficiently investigated. This study aims to demonstrate the independent effect of lipedema on osteoarthritis, evaluate clinical and ultrasonographic parameters together, and contribute to early diagnosis and targeted rehabilitation strategies.
Interventions
None listed
Sponsors
Izmir Democracy University
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
FEMALE
Age
30 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
All participants (Group 1 + Group 2) * Women aged 30-65 * With a clinical and radiological diagnosis of knee osteoarthritis * Who agreed to participate in the study Group 1 (knee osteoarthritis with lipedema): * Patients who meet the Wold criteria for a clinical diagnosis of lipedema * An increase in subcutaneous fat thickness confirmed by ultrasound Group 2 (knee osteoarthritis without lipedema): * No diagnosis of lipedema * Exclusion of lymphedema and venous diseases
Exclusion criteria
* Inflammatory arthritis * History of knee surgery * Intra-articular injection within the past 6 months * Acute trauma * Systemic connective tissue disease * Severe venous insufficiency or lymphedema * History of malignancy * Use of gabapentinoids/SNRIs/SSRIs due to fibromyalgia or psychiatric illness * Severe cognitive impairment or communication problems that would prevent participation in the study * Pregnancy * Participants who were informed about the study and refused to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ultrasonography-based measurements of femoral cartilage thickness | Day 1 | During femoral cartilage thickness measurements, participants will be positioned in the supine position, and the knee will be brought to maximum flexion for evaluation through the suprapatellar window. The probe will be positioned in the transverse plane, and measurements will be taken at the level of the medial and lateral femoral condyles and the intercondylar groove. For standardization, each measurement will be repeated three times, and the average will be recorded. Cartilage thickness will be defined as the distance between the hypoechoic cartilage layer and the subchondral bone surface. Lower values indicate that osteoarthritis has caused more structural damage. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Western Ontario and McMaster Universities (WOMAC) score | Day 1 | The WOMAC Osteoarthritis Index questionnaire, consisting of 5 questions using a Likert scale, is provided in the attached case report form to assess pain, stiffness, and daily living functions. The WOMAC Osteoarthritis Index consists of 24 questions covering three subscales: pain (5 questions), stiffness (2 questions), and function (17 questions). The scoring system consists of the WOMAC pain score, WOMAC stiffness score, WOMAC function score, and WOMAC total score. A Turkish validity and reliability study has been conducted. |
| Visual analog scale | Day 1 | Visual analog scale measures pain as it is subjectively perceived. It uses a 0-10 cm scale, the most commonly used tool for quantitatively determining pain intensity, with one end representing no pain and the other end representing the most severe pain possible. '0' indicates no pain, while '10' indicates the most severe pain. The individual is asked to select the numerical value that best represents their condition. This marked value is used as numerical data to determine the level of pain perception. A higher score indicates a higher level of pain. |
| Joint Range of Motion measurement | Day 1 | Knee flexion and extension will be measured bilaterally using universal goniometry to assess patients' joint range of motion, and the angles will be recorded. |
| Kellgren-Lawrence Classification | Day 1 | The Kellgren and Lawrence system is a widely used method that classifies the severity of knee osteoarthritis into five grades. |
| Assessment of osteophytes via ultrasonography | Day 1 | During osteophyte assessment, participants will be positioned in the supine position with the knee flexed approximately 30 degrees; the probe will be placed along the medial and lateral joint lines in the longitudinal and transverse planes to examine bony projections. Osteophytes will be scored according to the Outcome Measures in Rheumatology knee osteoarthritis scale criteria as small (\<2 mm - Grade 1), moderate (2-4 mm - Grade 2), and large (\>4 mm - Grade 3). |
| Assessment of synovial hypertrophy via ultrasonography | Day 1 | In the ultrasound assessment of synovial hypertrophy, the thickness of hypoechoic tissue in the suprapatellar region that does not shift upon probe compression will be measured, and values exceeding 2 mm will be recorded as synovial hypertrophy. |
| Assessment of synovial effusion via ultrasonography | Day 1 | Ultrasonographic assessment of joint effusion will be performed at the suprapatellar recess level; participants will be positioned in the supine position with the knee in near-extension or slight flexion. During the longitudinal plane examination, anechoic fluid collections will be measured, and values of 4 mm or greater will be considered pathological synovial effusions. |
| Assessment of meniscal protrusions via ultrasonography | Day 1 | During the ultrasound assessment of meniscus protrusion, the knee will be positioned with approximately 30 degrees of flexion, and the extent to which the meniscus tissue extends beyond the tibial margin will be evaluated in measurements taken in the longitudinal plane along the medial joint line; protrusions exceeding 3 mm will be considered pathological meniscus protrusions. |
| Ultrasonography-based measurements of quadriceps muscle thickness | Day 1 | For ultrasonographic measurements of quadriceps muscle thickness, participants will be positioned in the supine position with the knee extended and the muscles fully relaxed; measurements taken in the transverse plane at the midpoint between the anterior superior iliac spine and the superior pole of the patella will assess the thicknesses of the rectus femoris and vastus intermedius muscles together. |
| Ultrasonography-based measurements of quadriceps tendon thickness | Day 1 | Ultrasonographic measurements of the quadriceps tendon will be taken in the longitudinal plane immediately proximal to the superior pole of the patella while the knee is flexed to approximately 30 degrees, and the average of the measurements taken 5, 10, and 15 mm proximal to this point will be recorded |
| Ultrasonography-based measurements of patellar tendon thickness | Day 1 | Ultrasonographic assessment of the patellar tendon is performed with the knee flexed to 30 degrees, in the longitudinal plane from the apex of the patella distally, and the anteroposterior thickness is measured approximately 5 mm distal to the apex. |
Countries
Turkey (Türkiye)
Contacts
CONTACTKadir Songür, Assoc. Prof.
Outcome results
None listed