Assessment of Knee Osteoarthritis Severity using New Multifactorial Scale (KHIUS) in Northwest Syria

The present study aimed to identify the risk factors associated with knee osteoarthritis (OA) in Northwest Syria and to evaluate the reliability of our newly proposed Khatib-Khaled Idlib University Scale (KHIUS) in assessing knee OA severity. The study enrolled 101 patients with knee OA, diagnosed through X-ray at the orthopedic clinic. The Kellgren and Lawrence classification was employed to determine the X-ray knee OA grades. The erythrocyte sedimentation rate (ESR) value was obtained as a biomarker after excluding rheumatoid arthritis, other inflammatory diseases, and malignant tumors. The risk factors of knee OA assessed in our study included age, gender, BMI, and physical activity. Each patient completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and KHIUS to evaluate knee OA severity. Correlation coefficients of two scales, i.e., WOMAC and X-ray knee OA grading as well as KHIUS and X-ray knee OA grading, were determined. The mean age of the patients was 52.84 ± 9.74 years (age range 25-80 years). Most patients had low daily activity levels, and the left knee was the most affected. In our study, the correlation coefficient between WOMAC and KHIUS was strong (R: 80.3%, P < 0.01). The correlation coefficient between X-ray KL knee OA grades and WOMAC was moderate (R: 50.9%, P < 0.01), whereas the correlation coefficient between X-ray KL knee OA grades and KHIUS was comparatively stronger (R: 75.7%, P < 0.01).  KHIUS can be a reliable scale to assess knee OA severity and to guide the method of treatment by orthopedic surgeons. In addition, KHIUS is more closely related to X-ray KL knee OA grading than other clinical scales.