Primary Osteoarthritis Knee: establishing its cause, pathogenesis and treatment -A Prospective Case-Control Study

  • Agrawal R C
Keywords: Knee Osteoarthritis, Arthroplasty, Deficient Full Flexion, Deficient Full Extension, Contracture Correction Therapy


Background: The objectives of this analytical study were to compare two scores, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), Euroqol Group Health Status Score through Visual Analog Scale (EQVAS); Deficient Full Flexion (DFF) and Deficient Full Extension of knee at the beginning and end-point in two, Trial (G1) and Control (G2) groups of Primary Osteoarthritis Knee patients.

Material and Methods: In this study total patients were 125, in G1 - 100 and in G2 – 25. G1 group received hypothesized treatment, contracture correction therapy (CCT) while G2 did no therapy. WOMAC determination done by the questionnaire; EQVAS by vertical-scale and deficiencies by goniometer at 0, 6, 12 and 24 weeks. The CCT consisted of eight body postures, aimed to provide passive flexion or passive extension.

Results: The CCT receiving was associated with recovery (P 0.00) while non-receiving with deterioration (P 0.00). In G1, WOMAC improved: 71.70 to 3.68 and EQVAS 22.25 to 91.55 (P 0.00). In G2, WOMAC deteriorated score worsened from 53.00 to 71.88 and EQVAS 58.60 to 11.96 (P 0.00). DFF and DFE showed coinciding changes.

Conclusion: The cause, pathogenesis and treatment are deficient full flexion/deficient full extension; capsular contracture formation and passive flexion or passive extension respectively.


Download data is not yet available.


Michelle J Lespasio, Nicolas S Piuzzi, M Elain Husni, George F Muschler, AJ Guarino, Michael A Mont. Knee Osteoarthritis: A Primer. Perm J.2017;21:16-183.

Felson David T, Neogi T. Osteoarthritis. In: Jamson, Fauci, Kasper, Hauser, Longo, Loscalzo. editors. Harrison’s Principles of Internal Medicine. Vol 2. 20th ed. New York: Mc Graw Hill Education; 2018.p.2624-30.

Khanduja V, Khan S W. Hip and knee. In: Williams Norman S, O’connell Ronan P, Mc Caskie Andrew W, editors. Baily & Love’s Short Practice of Surgery, Vol 1, 27th ed. Great Britain: CRC Press; 2018.p.513.

Heidari Behzad, Knee Osteoarthritis prevalence, risk factors, pathogenesis & clinical features: Part I. Caspian J Intern Med. 2011 Spring; 2(2): 205-212.

Cherian JJ, Jauregui JJ, Leichliter AK, Elmallah RK, Bhave A, Mont MA. The effects of various physical non-operative modalities on the pain in osteoarthritis of knee. Bone Joint J.2016 Jan; 98B (1 Suppl A): 89-94.

Mihalko William M. In: Azar Frederick M, Beaty James H, Canale Terry S. editors. Campbell’s Operative Orthopedics, Vol 1, 13th ed. Philadelphia: Elsevier; 2017.p. 413-20.

Vaishya R, Vijay V, Agarwal AK. Total Knee Arthroplasty using patient specific blocks after prior femoral fracture without hardware removal. Indian J Orthop 2018;52:154-60.

Van der Woude J.A.D. Wiegant K. Heerwaarden van R.J. Struijt S Emans P.J. Mastheegen S.C. et al. Knee joint distraction compared with total knee arthroplasty. A Randomised Controlled Trial: Bone Joint J 2017;99-B:5-8.

Heidari Behzad, Knee Osteoarthritis diagnosis, treatment and associated factors of progression: part II Caspian J Intern Med.2011 Summer; 2(3): 249–55.

Dhaliwal U, Writing Aim and Objectives: Getting Clarity. In: Gupta P, Singh N. How to Write the Thesis and Thesis Protocol: A primer for Medical, Dental and Nursing Courses. First ed. Delhi: Jaypee Brothers Medical Publishers (P) Ltd. 2014. p.64.

Agrawal RC, Trial of a treatment on the patients of Primary Osteoarthritis Knee, Indian Journal of Physiotherapy and Occupational Therapy 2016;10:185-90.

Joshi M. Selecting the Research Design. In: Gupta P, Singh N editors. How to Write the Thesis and Thesis Protocol: A primer for Medical, Dental and Nursing Courses. First ed. Delhi: Jaypee Brothers Medical Publishers (P) Ltd.2014. p.33.

Clustered Randomized Trials.> research (date last accessed 30 August 2020).

WOMAC Osteoarthritis Index (Lk3.1).>GO-ON-Knee-or-Hip-WOMAC.pdf (date last accessed 30 August 2020).

Mandy Van Reenen / Bas Janseen. preparators. EQ-5D-5L User Guide: Basic information on how to use the EQ-5D-5L instrument; Version 2.1 April 2015.

Bulstrode CJK. Diseases of bone and joints: generalised diseases and chronic joint disorders. In: Russell RCG, Williams NS, Bulstrode CJK. editors. Baily & Love’s Short Practice of Surgery, London: Arnold; 2000. p.415.

Caroline W, Adams Michael A. Functional Anatomy of the Musculoskeletal system. In: Standring S, Borley Neil R, Collins P, Crossman Alan R, Gatzoulis Micheal A, Healy Jeramiah C et al. editors. Gray’s Anatomy, The Anatomical Basis of Clinical Practice. 40th ed. Elsevier: Churchill Livingstone; 2008. p.99.

Hamblen David L, Simpson RW Hamish A. editors. Osteoarthritis (Degenerative Arthritis; arthrosis; osteoarthrosis; hypertrophic arthritis; post-traumatic arthritis). In: Adams’s Outline of Orthopaedics.14thed.Edinburgh: Churchill Livingstone;2010. p.140.

Ralstone S.H, McInnes I.B. Rheumatology and bone diseases. In: Walker Brian R, Colledge Nicki R, Ralston Stuart H, Penman Ian D. editors. Davidson’s Principles and Practice of Medicine, 22nd ed. Edinburgh: Churchill Livingstone; 2014. p.1082.

Prakash J, Seon JK, Song EK, Lee DH, Yang HY, Jin C. Is combined administration of tranexamic acid better than both intravenous and topical regimes for total loss, hidden loss and post-operative swelling? a randomized control trial. Indian J Orthop 2018; 52:117-23.

Sigrici A. Pain management in total knee arthroplasty by intra-operative local anaesthetic application and one shot femoral block. Indian J Orthop 2017; 51:280-5.

How to Cite
Agrawal RC. Primary Osteoarthritis Knee: establishing its cause, pathogenesis and treatment -A Prospective Case-Control Study. ojmpc [Internet]. 2022Jul.1 [cited 2024Mar.2];28(01):36-3. Available from:
Original Article