{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:21:15Z","timestamp":1773400875984,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,1,29]],"date-time":"2020-01-29T00:00:00Z","timestamp":1580256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Osteoarthritis (<jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content>) is a major reason for chronic pain, stiffness, and functional limitation. This study was undertaken to analyze factors associated with the burden of <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content>, taking the pattern of joint involvement into account.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a random sample of 8,995 patients with <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, German Modification codes M15 [polyarticular], M16 [hip], or M17 [knee]) from a German statutory health insurance database, 3,564 patients completed a survey including the Western Ontario and McMaster Universities Osteoarthritis Index (<jats:styled-content style=\"fixed-case\">WOMAC<\/jats:styled-content>). Patients with knee, hip, concomitant hip and knee, or polyarticular manifestation were compared concerning pain, stiffness, function, and impact on work and personal life. Data were linked to dispensation records. The association of age, sex, body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>), symptom duration, and the World Health Organization\u20135 Well\u2010Being Index (<jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>\u20105) with <jats:styled-content style=\"fixed-case\">WOMAC<\/jats:styled-content> results was assessed in multiple linear regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with knee (n = 1,448), hip (n = 959), hip and knee (n = 399), or polyarthritic (n = 758) <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> were included. Concomitant hip and knee <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> was accompanied by the highest <jats:styled-content style=\"fixed-case\">WOMAC<\/jats:styled-content> values (mean 44), frequent impairment of personal life (75%), and the highest use of analgesics (52% nonsteroidal antiinflammatory drugs, 22% opioids, and 37% others). In the regression analyses, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> per 5 units and <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>\u20105 per 10% worsening were associated with an increase in <jats:styled-content style=\"fixed-case\">WOMAC<\/jats:styled-content> values of 4\u20135 points, irrespective of the joint manifestations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Disease burden is high in patients with concomitant hip and knee <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> and is connected with frequent prescription of analgesics. Involvement of several joints, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>, and depressive symptoms need to be considered when using the <jats:styled-content style=\"fixed-case\">WOMAC<\/jats:styled-content> as an outcome instrument.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24058","type":"journal-article","created":{"date-parts":[[2019,9,3]],"date-time":"2019-09-03T15:40:07Z","timestamp":1567525207000},"page":"193-200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Disease Burden of Patients With Osteoarthritis: Results of a Cross\u2010Sectional Survey Linked to Claims Data"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3923-2728","authenticated-orcid":false,"given":"Johanna","family":"Callhoff","sequence":"first","affiliation":[{"name":"German Rheumatism Research Centre  Berlin 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