Osteoarthritis (OA) of the knee is the most common form of degenerative joint disease and a leading cause of chronic pain, disability, and reduced quality of life among middle-aged and elderly individuals worldwide. It is characterized by progressive degeneration of articular cartilage, subchondral bone sclerosis, osteophyte formation, and varying degrees of synovial inflammation, ultimately resulting in joint deformity and loss of function [1,2]. The knee joint, being a major weight-bearing articulation, is particularly susceptible to degenerative changes, thereby contributing substantially to mobility limitation and socioeconomic burden in aging populations [2]. Globally, the prevalence of knee OA has been increasing due to population aging, obesity, sedentary lifestyles, and improved life expectancy. Epidemiological data indicate that OA affects nearly one-third of adults over 50 years, with knee OA ranking among the top ten causes of disability worldwide [1]. In India, community-based studies have reported prevalence rates ranging from 22% to 39%, with a higher burden among women and individuals residing in rural areas engaged in manual labor [2,3]. The development and progression of knee OA are influenced by several interrelated risk factors including advancing age, female sex, obesity, hormonal changes after menopause, genetic predisposition, and prior joint injury [3–5]. Notably, female hormonal decline post-menopause has been shown to exacerbate cartilage loss and accelerate disease progression [5]. Clinically, OA knee often presents insidiously with pain on activity, stiffness, crepitus, swelling, and restricted movement, gradually impairing daily activities and ambulation. The present study was undertaken to determine the prevalence and clinical profile of osteoarthritis of the knee among patients attending the Orthopaedic Outpatient Department of Government General Hospital, Mancherial. The study also aimed to analyze the association between demographic and clinical variables—such as age, gender, obesity, and comorbidities—and the radiological severity and functional disability of knee osteoarthritis.

A cross-sectional observational study was conducted in the Department of Orthopaedics, Government General Hospital (GGH), Mancherial, from July 2025 to August 2025. The study aimed to determine the prevalence and clinical profile of osteoarthritis (OA) knee among patients attending the orthopaedic outpatient department. Study Population All adult patients aged ≥40 years presenting with knee pain of at least three months’ duration were screened. Those fulfilling the American College of Rheumatology (ACR) clinical criteria for knee osteoarthritis were included in the study. Inclusion Criteria Patients aged 40 years and above. Clinically and radiologically diagnosed cases of primary osteoarthritis of the knee. Patients who provided informed consent to participate. Exclusion Criteria Secondary osteoarthritis due to trauma, infection, or inflammatory arthritis (e.g., rheumatoid arthritis, gout). Patients with previous knee surgery or fracture involving the knee joint. Patients unwilling to participate in the study. Sample Size A total of 150 patients meeting the inclusion criteria were enrolled using a consecutive sampling method during the study period. Data Collection A predesigned proforma was used to record demographic details (age, gender, occupation, residence), clinical history, and risk factors such as obesity, comorbidities, menopausal status, and family history. Each patient underwent a detailed musculoskeletal examination including assessment of pain, stiffness, joint tenderness, deformity, and range of motion. Radiological and Functional Assessment Standard anteroposterior and lateral radiographs of the knee were obtained and graded using the Kellgren–Lawrence (KL) classification system. Functional status was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Statistical Analysis Data were analyzed using SPSS software version 26.0. Descriptive statistics were applied for demographic and clinical variables. The association between radiological severity and risk factors such as age, BMI, and duration of symptoms was assessed using the chi-square test, and a p-value < 0.05 was considered statistically significant.

A total of 150 patients clinically diagnosed with osteoarthritis (OA) of the knee were included in this cross-sectional study. The overall prevalence of OA knee among outpatients attending the orthopaedic clinic during the study period was 27.3%. Demographic Characteristics The mean age of participants was 57.8 ± 8.9 years, with the majority belonging to the 51–60 years age group (42%), followed by 61–70 years (31%). Females constituted 64%, while males accounted for 36%, yielding a female-to-male ratio of 1.8:1. Most patients (70%) were from rural backgrounds and engaged in moderate to heavy physical activity, as shown in Table 1. Table 1. Demographic Characteristics of Patients with Osteoarthritis Knee (n = 150) Parameter Category n (%) / Mean ± SD Mean age (years) – 57.8 ± 8.9 Age distribution (years) 41–50 27 (18%) 51–60 63 (42%) 61–70 47 (31%) >70 13 (9%) Gender Male 54 (36%) Female 96 (64%) Residence Rural 105 (70%) Urban 45 (30%) Physical activity level Moderate to heavy 105 (70%) Sedentary 45 (30%) Risk Factors and Comorbidities The most common associated risk factor was obesity (56%), followed by positive family history (38%), hypertension (44%), and type 2 diabetes mellitus (32%). Among the female patients, 60% were postmenopausal, suggesting a potential hormonal influence on disease occurrence. A smaller subset (15%) reported a history of knee injury or occupational overuse. These findings are summarized in Table 2. Table 2. Distribution of Risk Factors and Comorbidities Risk Factor / Comorbidity n (%) Obesity (BMI ≥25 kg/m²) 84 (56%) Positive family history 57 (38%) Hypertension 66 (44%) Type 2 diabetes mellitus 48 (32%) Postmenopausal women 58 (60% of females) History of knee injury / overuse 22 (15%) Clinical Presentation All patients presented with pain on activity (100%), followed by stiffness (78%) and crepitus (65%). Bilateral involvement of the knees was more frequent (68%) than unilateral (32%). On clinical examination, medial joint line tenderness (72%) and reduced terminal flexion (59%) were the predominant findings, as detailed in Table 3. Table 3. Clinical Presentation and Examination Findings Clinical Feature n (%) Pain on activity 150 (100%) Stiffness 117 (78%) Crepitus 98 (65%) Bilateral involvement 102 (68%) Unilateral involvement 48 (32%) Medial joint line tenderness 108 (72%) Reduced terminal flexion 89 (59%) Radiological Severity and Functional Impact Based on the Kellgren–Lawrence grading system, Grade II changes were most prevalent (46%), followed by Grade III (30%), Grade I (18%), and Grade IV (6%). Assessment using the WOMAC functional score revealed moderate disability in 58%, severe disability in 24%, and mild symptoms in 18%. A statistically significant positive correlation (p < 0.05) was observed between radiological severity and age, BMI, and symptom duration, indicating that disease severity increases with advancing age and higher body mass index (Table 4). Table 4. Radiological Severity and Functional Disability Parameter Category n (%) Kellgren–Lawrence (KL) Grade Grade I 27 (18%) Grade II 69 (46%) Grade III 45 (30%) Grade IV 9 (6%) WOMAC Functional Disability Mild 27 (18%) Moderate 87 (58%) Severe 36 (24%) Correlation (p-value) Age, BMI, duration vs. KL grade p < 0.05

The present study assessed the prevalence and clinical profile of osteoarthritis (OA) of the knee among patients attending the orthopaedic outpatient department of Government General Hospital, Mancherial. The overall prevalence of knee OA was 27.3%, which corresponds with previously reported Indian data indicating a prevalence between 22% and 39% among individuals over 40 years, reaffirming that OA knee remains a leading cause of morbidity in the aging population. The mean age of 57.8 years observed in this study aligns with previous literature, which consistently places the peak incidence of OA knee in the fifth and sixth decades of life. The predominance of the 51–60-year age group underscores the cumulative effects of mechanical wear, hormonal decline, and diminished cartilage regeneration that accompany aging. The female preponderance (64%) in our cohort supports established evidence implicating estrogen deficiency, reduced bone mineral density, and higher rates of obesity in postmenopausal women as major contributors to disease vulnerability [6]. In our study, obesity (56%) emerged as the most significant modifiable risk factor, a finding consistent with recent reviews emphasizing the dual mechanical and metabolic burden of excess weight on knee joints [6]. Obesity not only increases articular load but also promotes systemic low-grade inflammation, accelerating chondrocyte degradation. Additionally, hypertension (44%) and type 2 diabetes (32%) were common comorbidities, supporting the growing recognition of a metabolic phenotype of OA linked to insulin resistance, oxidative stress, and proinflammatory adipokines [7,8]. The clinical profile in our study pain on activity, stiffness, and crepitus—mirrors classical descriptions of symptomatic OA knee [9]. Bilateral involvement (68%) was more frequent than unilateral disease, corroborating observations that degenerative changes typically affect both load-bearing joints symmetrically [10]. Radiographically, Kellgren–Lawrence Grades II and III predominated, reflecting moderate disease severity in the majority of cases. Functional assessment using the WOMAC index revealed that 58% of participants experienced moderate disability, aligning with population-based findings indicating substantial quality-of-life impairment among OA patients [11]. Importantly, our study found a significant positive correlation between radiographic grade, age, and body mass index (p < 0.05), consistent with previous evidence confirming that structural severity correlates with symptom intensity and mobility restriction [12].

The present study highlights that osteoarthritis of the knee is a common degenerative joint disorder, particularly affecting middle-aged and elderly individuals, with a marked predominance among postmenopausal women. Advancing age, obesity, and female gender emerged as major contributing factors, while comorbidities such as hypertension and diabetes further aggravated disease severity. Pain, stiffness, and functional limitation were universal features, with most patients exhibiting moderate radiological and functional impairment. Early diagnosis, lifestyle modification, weight reduction, and physiotherapy play crucial roles in delaying disease progression and improving mobility. Public health initiatives promoting joint health awareness are essential to reduce the overall burden of osteoarthritis knee.

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