Quality of Life Research

, Volume 14, Issue 3, pp 795–803 | Cite as

Health-related and overall quality of life of patients with chronic hip and knee complaints in general practice

  • Johanna M. van der WaalEmail author
  • Caroline B. Terwee
  • Daniëlle A. W. M. van der Windt
  • Lex M. Bouter
  • Joost Dekker


Background: Information about quality of life of patients with chronic hip or knee complaints in general practice is scarce. This study describes the health-related and overall quality of life (HRQL) of these complaints. Methods: Data were obtained from a cohort study in general practice. HRQL at three months follow-up was analysed. HRQL was measured as: symptoms, physical, psychological and social functioning, and general health perceptions, using the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and the MOS 36-item short-form-health survey (SF-36). Overall quality of life was measured using a 5-point rating scale. Results: The results show that patients with chronic hip or knee complaints have a substantial lower HRQL compared to patients who had recovered from baseline hip or knee complaints. The largest effect was found on symptoms and physical functioning: up to 2.9 standard deviations below patients who had recovered from baseline hip or knee complaints. Scores of patients with both chronic hip and knee complaints were significantly worse than scores of patients with only knee complaints on most subscales. Conclusion: In patients with chronic hip or knee complaints the worst scores were seen on scales that measure symptoms and physical functioning, but still a substantially lower score was obtained for overall quality of life. Quality of life was poorer for patients with both chronic hip and knee complaints compared to those with chronic hip or knee complaints only.


Burden of illness Hip Knee Quality of life 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Picavet HS, Schouten JSAG. Musculoskeletal pain in the Netherlands: Prevalences, consequences and risk groups, the DMC3-study. In: Public Health Questions on Physical Disabilities and Musculoskeletal Conditions–Studies Using Health Surveys, Thesis, Wageningen Universiteit, The Netherlands, Chapter 4, 1 January 2001; pp. 65–80.Google Scholar
  2. Okkes, IM, Oskam, SK, Lamberts, H. 1998Van klacht naar DiagnoseEpisodegegevens uit de HuisartspraktijkUitgeverij Coutinho, Bussum Google Scholar
  3. Elliott, AM, Smith, BH, Penny, KI, Smith, WC, Chambers, WA 1999The epidemiology of chronic pain in the community.Lancet35412481252Google Scholar
  4. Straaton, KV, Fine, PR 1997Addressing work disability through vocational rehabilitation services.Bull Rheum Dis4613Google Scholar
  5. Hoffman, C, Rice, D, Sung, HY 1996Persons with chronic conditions.Their prevalence and costs.JAMA27614731479Google Scholar
  6. Odding, E, Valkenburg, HA, Algra, D, Vandenouweland, FA, Grobbee, DE, Hofman, A 1995Association of locomotor complaints and disability in the Rotterdam study.Ann Rheum Dis54721725Google Scholar
  7. Reginster, JY, Khaltaev, NG 2002Introduction and WHO perspective on the global burden of musculoskeletal conditions.Rheumatology4112(Supp 1), (Oxford)Google Scholar
  8. Woolf, AD, Akesson, K 2001Understanding the burden of musculoskeletal conditions. The burden is huge and not reflected in national health priorities.Br Med J32210791080Google Scholar
  9. Focal Point of Bone and Joint Decade is Determining Burden of Disease. American College of Rheumatology News, 2001; p. 20.Google Scholar
  10. Birrell, F, Croft, P, Cooper, C, Hosie, G, Macfarlane, G, Silman, A 2000Health impact of pain in the hip region with and without radiographic evidence of osteoarthritis: A study of new attenders to primary care. The PCR Hip Study Group.Ann Rheum Dis59857863Google Scholar
  11. Verbrugge, LM, Jette, AM 1994The disablement processSoc Sci Med38114Google Scholar
  12. Wilson, IB, Cleary, PD 1995Linking clinical variables with health-related quality of life.A conceptual model of patient outcomes.JAMA2735965Google Scholar
  13. Westert GP, Schellevis FG, de Bakker DH, Groenewegen PP, Bensing IM, van der Zee J. Monitoring health inequalities through general practice: The Second Dutch National Survey of General Practice. Eur J Public Health, in press.Google Scholar
  14. Lamberts, H, Wood, M 1987International Classification of Primary Care.Oxford University PressNew YorkGoogle Scholar
  15. van, der Waal JM, Bot, SD, Terwee, CB, van der Windt, DA, Bouter, LM, Dekker, J. 2003Determinants of the clinical course of musculoskeletal complaints in general practice: Design of a cohort studyBMC Musculoskelet Disord43Google Scholar
  16. Bellamy, N, Buchanan, WW, Goldsmith, CH, Campbell, J, Stitt, LW 1988Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.J Rheumatol1518331840PubMedGoogle Scholar
  17. McConnell, S, Kolopack, P, Davis, AM 2001The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): A review of its utility and measurement properties.Arthritis Rheum45453461Google Scholar
  18. Roorda, LD, Jones, CA, Waltz, M,  et al. 2004Satisfactory cross cultural equivalence of the Dutch WOMAC in patients with hip osteoarthritis waiting for arthroplasty.Ann Rheum Dis633642Google Scholar
  19. Ware, JE,Jr, Sherbourne, CD 1992The MOS 36-item short-form health survey (SF-36).I. Conceptual framework and item selection.Med Care30473483PubMedGoogle Scholar
  20. Sprangers, MA, de Regt, EB, Andries, F,  et al. 2000Which chronic conditions are associated with better or poorer quality of life?J Clin Epidemiol53895907Google Scholar
  21. Aaronson NK, Muller M, Cohen PD, et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 1998; 1055–1068.Google Scholar
  22. Cohen, J 1988Statistical Power Analysis for the Behavioral Sciences2Lawrence Erlbaum AssociatesHills Dale, NJGoogle Scholar
  23. Norman, GR, Sloan, JA, Wyrwich, KW 2003Interpretation of changes in health-related quality of life: The remarkable universality of half a standard deviation.Med Care41582592Google Scholar
  24. Haggerty, CL, Ness, RB 2003What is chronic pain?Ann Epidemiol13584585Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Johanna M. van der Waal
    • 1
    Email author
  • Caroline B. Terwee
    • 1
  • Daniëlle A. W. M. van der Windt
    • 1
    • 2
  • Lex M. Bouter
    • 1
  • Joost Dekker
    • 1
    • 3
  1. 1.Institute for Research in Extramural Medicine (EMGO Institute)VU University Medical CenterAmsterdamThe Netherlands
  2. 2.Department of General PracticeNetherlands
  3. 3.Department of Rehabilitation Medicine VU University Medical CenterAmsterdamThe Netherlands

Personalised recommendations