Effect of vitamin b12 deficiency on radiological staging and functional status in patients with gonartrosis

ABSTRACT The aim of this study was to evaluate the effect of vitamin B12 deficiency on functional status and radiologic stage in patients with gonarthrosis. Sixty-three patients who met the American College of Rheumatology diagnostic criteria for osteoarthritis of the knee were included in the study. Knee radiographs were taken in all patients and evaluated according to the radiologic staging scale of Kellgren and Lawrence. Visual analog scale (VAS), The Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC), Lequesne Knee Osteoarthritis Index, Nottingham Health Profile (NHP) were used for pain, function and quality of life questionnaires. Neuropathic pain status was assessed with the Leeds Neuropathic Symptom and Sign Rating Scale (LANSS). Cognitive functions of the patients were evaluated by Mini Mental State Examination (MMSME). The Hospital Anxiety and Depression (HAD) scale was used to assess patients' mood. Complete blood count, red blood cell sedimentation values, serum CRP, ALT, AST, ALP, urea, creatinine, indirect bilurubin, vitamin B12, RF levels were recorded for routine controls. Range of motion, lower extremity manual muscle strength, superficial and deep sensory examination, reflex examination, Romberg test and tandem gait to evaluate balance, toe-to-nose test, heel-to-knee test, dysdiadokinesia, rebound test to evaluate coordination were performed. Patients were visually evaluated for gait pattern. Vitamin B12 deficiency was detected in 31 (49.2%) of sixty-three patients with osteoarthritis (OA) Vitamin B12 levels were within normal limits in 32 (50.8%) patients. All patients were classified as vitamin B12 deficient and non-vitamin B12 deficient. No significant difference was observed between the two groups in pain, function and quality of life questionnaires, LANSS and MMDM tests (p>0.05). HAD-anxiety score was significantly higher in the group with vitamin B12 deficiency (P<0.05). The rate of positive romberg test was significantly higher in the group with vitamin B12 deficiency (p<0.05). Anemia findings were significantly higher in the group with vitamin B12 deficiency (p<0.05). In conclusion, vitamin B12 deficiency did not have an effect on pain, functional impairment and radiologic staging in patients with knee osteoarthritis, but more comprehensive studies are needed because our study group was small. Key Words: Osteoarthritis, Knee, Pain, Vitamin B12 deficiency