Cardiovascular fitness and health in patients with end-stage osteoarthritis

To evaluate the cardiovascular fitness of a group of patients with severe osteoarthritis (OA).

Thirty-seven patients with end-stage OA were evaluated just before hip or knee replacement surgery. Severity of arthritis was evaluated using standardized techniques. Patients and age- and sex-matched controls underwent a single, maximal, symptom-limited, cardiopulmonary exercise test using arm or leg ergometry and a metabolic cart to measure expired respiratory gases.

Severe musculoskeletal disability and deformity was confirmed in the OA patient group. During exercise testing, OA patients were able to perform physiologically maximal cardiopulmonary exercise. Arthritis patients were noted to be severely deconditioned, with reduced peak oxygen consumption (OA hips mean +/- SD 14.9 +/- 4.2 versus control hips 19.0 +/- 4.6, P < 0.0001; OA knees 12.8 +/- 3.7 versus control knees 17.6 +/- 5.2 ml/kg/minute, P < 0.0005). A trend for more frequent manifestations of coronary heart disease in OA patients than in controls (27% versus 13%; P > 0.05) was also noted.

Patients with end-stage lower extremity OA are severely deconditioned. This may place them at incremental risk for the development of coronary heart disease.