Correlates of knee pain in older adults: Tasmanian older adult cohort study

Abstract

Objective. To describe the association between chondral defects, bone marrow lesions, knee and hip radiographic osteoarthritis (OA), and knee pain. Methods. Knee pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index. T1-and T2-weighted fat saturation magnetic resonance imaging was performed on the right knee to assess chondral defects and subchondral bone marrow lesions. Radiography was performed on the right knee and hip and scored for radiographic OA. Body mass index (BMI) and knee extension strength were measured. Results. A total of 500 randomly selected men and women participated. The prevalence of knee pain was 48%. In multivariable analysis, prevalent knee pain was significantly associated with medial tibial chondral defects (odds ratio [OR] 2.32, 95% confidence interval [95% CI] 1.02-5.28 for grade 3 versus grade 2 or less; OR 4.93, 95% CI 1.07-22.7 for grade 4 versus grade 2 or less), bone marrow lesions (OR 1.44, 95% CI 1.04 -2.00 per compartment), and hip joint space narrowing (OR 1.36, 95% CI 1.07-1.73 per unit), as well as greater BMI and lower knee extension strength. It was not significantly associated with radiographic knee OA. These variables were also associated with more severe knee pain. In addition, there was a dose response association between knee pain and number of sites having grade 3 or 4 chondral defects (OR 1.39, 95% CI 1.12-1.73 per site), with all subjects having knee pain if all compartments of the knee had these defects. Conclusion. Knee pain in older adults is independently associated with both full and non-full-thickness medial tibial chondral defects, bone marrow lesions, greater BMI, and lower knee extension strength, but is not associated with radiographic knee OA. The association between radiographic hip OA and knee pain indicates that referred pain from the hip needs to be considered in unexplained knee pain. KEY WORDS. Knee pain; Chondral defects; Bone marrow lesions; Knee and hip radiographic OA.

Gender Differences in the Correlation between Symptom and Radiographic Severity in Patients with Knee Osteoarthritis

“…Demographic information included gender, age, height, weight, and BMI, which are associated with symptom severity in knee OA [16,28,29,41,44]. Symptom severity was measured using the WO-MAC index and the SF-36 scale.…”

“…Many authors have investigated the relationship between symptom and radiographic severity [5,8,9,11,24,26,29,31,38,44], and some authors found an association between them [9,24,31,38], while others did not [5,8,11,26,29,44]. However, the previous studies had limitations including limited radiographic views that might underestimate the structural abnormalities [5,8,31,44] and unclear definitions of knee OA symptoms such as the mere presence of pain without using validated outcome scales [9,15,24,45].…”

“…However, the previous studies had limitations including limited radiographic views that might underestimate the structural abnormalities [5,8,31,44] and unclear definitions of knee OA symptoms such as the mere presence of pain without using validated outcome scales [9,15,24,45]. Furthermore, most previous studies were limited by focusing on the relationship between symptom and specific radiographic findings such as osteophyte, joint space narrowing and subchondral sclerosis [8,9,11,24,31,44]. Overall radiographic grades may help physicians counsel patients in practice, and the K/L grading system has been frequently utilized for that purpose [7,16,23].…”

The Knee injury and Osteoarthritis Outcome Score reflects the severity of knee osteoarthritis better than the revised Knee Society Score in a general Japanese population

“…Population-based normative data for the KOOS were reported and stratified by age and sex [21]. A previous study found that lower knee extension strength and higher BMI were associated with knee pain [4]. The relationship between radiographic knee OA and quadriceps strength has also been reported [22].…”

“…Various risk factors associated with the incidence and progression of OA have been identified, including aging, high body mass index (BMI), female sex, previous knee injury, quadriceps muscle strength, and knee malalignment, among others [1][2][3][4]. Of these, obesity and quadriceps muscle strength are important for the prevention and suppression of the disease.…”