Observations on Severe Grades of Knee Osteoarthritis in Patients Residing in Hilly Areas Presenting to a Peripheral Hospital in North Kashmir

Purpose: To observe the severity of knee osteoarthritis in patients residing in the hilly areas presenting to a peripheral rural hospital in North Kashmir. Patients and Methods: 100 patients with age more than 40 years with moderate grade (Kellgren-Lawrence grade 3) and severe grade (Kellgren-Lawrence grade 4) osteoarthritis of knees were included in this study. Patients demographic profile including name, age, sex, residence, occupation and the chief complaints were noted and knees were examined clinically. Knee radiographs were taken and radiographic signs for osteoarthritis were interpreted. Osteoarthritis was graded using the Kellgren and Lawrence grading for osteoarthritis. Flexion deformity and varus deformity was clinically measured. Patients were treated symptomatically for short term pain relief using NSAIDs, Opoid analgesics and intraarticular knee corticosteroid injections. Patients were followed weekly for more than eight visits and option of definitive treatment (i. e; Total knee arthroplasty) was explained and discussed. Results: Majority of patients (75 %, 75 cases) were in the age group of 50-58 years with an average age of 53 years. The number of females was more than males, with a total of 62 females and 38 males. Left knee was predominantly affected in 14 % (14 cases), right knee predominantly in 11 % (11 cases) and both knees were involved in 75 % of the cases. Bicompartment osteoarthritis was seen in 42, while tricompartment osteoarthritis in 58. Grade 3 osteoarthritis was found in 55 and grade 4 osteoarthritis was noted in 45 patients. Fixed flexion deformity (FFD) upto 10 degrees was found in 38 patients, FFD of 10-20 degrees in 22 patients, 20-30 degrees in 17 patients and more than 30 degrees in 12 patients. Varus deformity of