Journal of Rehabilitation Medicine 51-8 | Page 39

J Rehabil Med 2019; 51: 575–581 ORIGINAL REPORT ELEVATED PREVALENCE OF OSTEOARTHRITIS AMONG ADULTS WITH CEREBRAL PALSY Zachary P. FRENCH, MD 1 , Rachael V. TORRES, BS 2 and Daniel G. WHITNEY, PhD 1 From the 1 Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI and 2 Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA Objective: Adults with cerebral palsy have an in- creased risk of developing osteoarthritis. However, little is known about the epidemiology of osteo- arthritis among this vulnerable population. The ob- jectives of this study were to compare the prevalen- ce of osteoarthritis between adults with and without cerebral palsy, and to determine how the prevalence of osteoarthritis changes throughout adulthood for each group. Design: Data were extracted from the 2016 Optum Clinformatics® Data Mart, a nationwide database of de-identified US insurance claims, containing medi- cal and pharmacy information on beneficiaries. Subjects: International Classification of Diseases 10 th revision (ICD-10) codes were used to identify adults (18+ years) with (n  = 7,348) and without (n  = 8.7 million) cerebral palsy. Methods: ICD-10 codes were used to identify osteo- arthritis. Prevalence of osteoarthritis was compared between adults with and without cerebral palsy be- fore and after adjusting for age and sex. The pre- valence of any type of osteoarthritis was compared between men and women with and without cerebral palsy, stratified by the following age groups: 18–30, 31–40, 41–50, 51–60, 61–70, and > 70 years. Results: Adults with cerebral palsy had higher preva- lence and adjusted odds of any, poly, hip, knee, and other/unspecified osteoarthritis (odds ratio (OR): 1.3–2.1; p  < 0.001), but not hand osteoarthritis (OR: 0.86; p  = 0.46). Men and women with cerebral palsy had a higher prevalence of any osteoarthritis compa- red with adults without cerebral palsy across all age groups (all p  < 0.05). Conclusion: Privately-insured adults with cerebral palsy had a higher prevalence of osteoarthritis com- pared with adults without cerebral palsy across the adult lifespan. Key words: osteoarthritis; epidemiology; cerebral palsy. Accepted Jul 3, 2019; Epub ahead of print Jul 8, 2019 J Rehabil Med 2019; 51: 575–581 Correspondence address: Daniel G. Whitney, Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA. E-mail: [email protected] O steoarthritis (OA) is a pathological condition of the synovial joints, characterized by localized articular cartilage damage and loss of tissue. OA is a debilitating condition associated with pain, fati- LAY ABSTRACT The aim of this study was to compare the prevalence of osteoarthritis between adults with and without ce- rebral palsy. Data were collected from the 2016 Optum Clinformatics® Data Mart, a nationwide de-identified US insurance claims database, containing medical and pharmacy information on beneficiaries. International Classification of Diseases 10 th revision (ICD-10) codes were used to identify adults (age 18+ years) with and without cerebral palsy. ICD-10 codes were also used to identify osteoarthritis. Prevalence of osteoarthritis was compared between adults with (n  = 7,348) and without (n  = 8.7 million) cerebral palsy, before and after adjus- ting for age and sex. The results showed that adults with cerebral palsy had a higher prevalence and ad- justed odds of any, poly, hip, knee, and other/unspeci- fied osteoarthritis. Men and women with cerebral palsy had a higher prevalence of any osteoarthritis compared with men and women without cerebral palsy across all age groups. Adults with cerebral palsy had a higher pre- valence of osteoarthritis compared with adults without cerebral palsy across the adult lifespan. gue, activity-interference (1), frailty (2) and reduced quality of life (3). OA accounts for a considerable economic burden (3). The burden of OA, determined by disability-adjusted life-years, has increased by 35% over recent decades (4); OA is now a leading cause of global disability (5). Risk factors for OA include age, sex, excess body fat, and joint-related stress injury (6). Populations with paediatric-onset biomechanical alterations and musculoskeletal deficits may be at risk for developing early-onset OA, which can negatively impact rehabilitation strategies aimed at improving function and health. Cerebral palsy (CP) is a neurological syndrome that results from a non-progressive disturbance to the cen- tral nervous system around the time of birth, and is the most common paediatric-onset physical disability (7). The majority of individuals with CP have musculos- keletal malformations, muscle spasticity, and flexion contractures, which alter biomechanics and increase localized joint stress. Children with CP also have low levels of physical activity and an underdeveloped musculoskeletal system (8). As a result, the prevalence of musculoskeletal disease in young adults with CP is more than 10 times higher than in those without CP (9). Furthermore, disparities in the prevalence of This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm Journal Compilation © 2019 Foundation of Rehabilitation Information. ISSN 1650-1977 doi: 10.2340/16501977-2582