The relationship between symptom duration in lumbar disc herniation and the prevalence of hip and knee osteoarthritis: A cross-sectional study.

OBJECTIVE: Degenerative spine disease commonly presents as lumbar disc herniation (LDH), a major cause of radiculopathy. Altered biomechanics may contribute to secondary joint pathology; however, the relationship between LDH-associated radiculopathy and hip or knee osteoarthritis (OA) remains unclear. RESEARCH QUESTION: This study evaluated the association between symptoms due to LDH and the presence and laterality of hip and knee symptomatic radiographic OA. MATERIAL AND METHODS: We analyzed data from a prospectively designed institutional study involving patients undergoing microdiscectomy for LDH. Consequently, this study evaluated exclusively symptomatic radiographic OA. Preoperative assessment included pain intensity, disability and motor deficit. Based on predefined clinical criteria (joint pain, stiffness, or restricted range of motion), symptomatic patients underwent targeted orthopedic and radiographic assessment for hip and knee OA. RESULTS: A total of 1344 patients were included. Longer duration of LDH-associated symptoms was associated with a higher prevalence of hip and knee symptomatic radiographic OA. A significantly higher prevalence of hip (OR = 34.9, 95% CI (10.0; 121.9) and knee (OR = 6.5, 95% CI (2.0; 20.7) symptomatic radiographic OA was observed in patients with a radicular motor deficit lasting >24 months versus those with symptoms ≤1 month.Radiculopathy laterality corresponded with ipsilateral joint involvement. DISCUSSION AND CONCLUSION: The study demonstrates that a significant association appears to exist between the duration of radicular symptoms and the prevalence of lower limb symptomatic radiographic OA. However, because this study population consists entirely of surgically treated individuals, these findings may limit generalizability to the broader, non-surgical population.