Relationship of Radiographic Findings With Pain, Function, Physical Performance and Balance

Primary outcomes

1. Kellgren-Lawrence Classification

   Time frame: Single assessment at enrollment

   This assessment, acknowledged by the World Health Organization as the definitive standard for the radiographic classification of osteoarthritis, shall be conducted by a qualified orthopaedic specialist. The evaluation will be based on radiographic imaging obtained in both the sagittal and frontal planes while the patient maintains an upright stance. Utilizing the 0-4 severity grading system, a score of '0' denotes the absence of osteoarthritis, whereas a score of '4' signifies advanced, severe osteoarthritic changes.

2. Western Ontario and McMaster University Osteoarthritis Index (WOMAC)

   Time frame: Single assessment at enrollment

   This index, employed for the evaluation of pain, stiffness, and functional impairment, has demonstrated validity and reliability in patients diagnosed with Knee Osteoarthritis (KOA) and Hip Osteoarthritis (HOA), with Intraclass Correlation Coefficients (ICC) ranging from 0.80 to 0.90. It comprises 24 items, each rated on a 5-point Likert scale from 0 to 4, where 0 indicates absence of symptoms, 1 signifies mild symptoms, 2 denotes moderate severity, 3 corresponds to severe symptoms, and 4 reflects extreme severity.

3. Timed Up and Go Test (TUG)

   Time frame: Single assessment at enrollment

   The procedure will initiate with participants seated upright in a chair with their arms resting on their laps. The time required for each participant to rise from a chair elevated to 45 centimeters, traverse a distance of 3 meters at maximum effort, execute a turnaround, and return to the original chair to sit will be measured in seconds utilizing a stopwatch. Following a preliminary trial, the mean duration from two recorded trials will be calculated for analysis.

4. Four Square Step Test

   Time frame: Single assessment at enrollment

   The assessment of dynamic balance will be conducted utilizing the four-square step test. The test environment will be delineated by arranging bars, each measuring 90 cm in length, in a '+' configuration. The squares will be sequentially numbered clockwise from 1 to 4, commencing with the bottom left square. Participants will be instructed to traverse the squares following the sequence: 2 → 3 → 4 → 1 → 4 → 3 → 2 → 1. The time required to complete the sequence will be measured in seconds using a stopwatch. Following an initial practice trial, the average of two recorded trials will be calculated for analysis.