Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

Glass, Natalie; Segal, Neil A.; Sluka, Kathleen A.; Torner, James C.; Nevitt, Michael C.; Felson, David T.; Bradley, Laurence A.; Neogi, Tuhina; Lewis, Cora E.; Law, Laura Frey

doi:10.1016/j.joca.2014.06.030

Cited by 106 publications

(89 citation statements)

References 47 publications

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“…In persons recruited from the community and clinic with symptomatic knee OA by ACR criteria, different quantitative sensory testing measures were associated with clinical pain in African-Americans and non-Hispanic Caucasians; reduced pain inhibition was important in all groups (71). Women in the Multicenter Osteoarthritis Study reported greater knee pain than men regardless of KL grade; differences decreased with adjustment for widespread pain (72). Higher BMI was associated with greater knee pain accounting for OA severity in persons with or at high risk for knee OA in the Osteoarthritis Initiative (73).…”

Section: Resultsmentioning

confidence: 99%

Osteoarthritis year in review 2015: clinical

Sharma

2016

Osteoarthritis and Cartilage

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The purpose of this review is to highlight clinical research in osteoarthritis. A literature search was conducted using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) with the search terms “osteoarthritis [All Fields] AND treatment [All Fields]” and the following limits activated: humans, English language, all adult 19+ years, published between April 1, 2014 and April 1, 2015. A second literature search was then conducted with the search terms “osteoarthritis [All Fields] AND epidemiology [All Fields]”, with the same limits. Reports of surgical outcome, case series, surgical technique, tissue sample or culture studies, trial protocols, and pilot studies were excluded. Of 1523, 148 were considered relevant. Among epidemiologic and observational clinical studies, themes included physical activity, early knee OA, and confidence/instability/falls. Symptom outcomes of pharmacologic treatments were reported for methotrexate, adalimumab, anti-nerve growth factor monoclonal antibodies, strontium ranelate, bisphosphonates, glucosamine, and chondroitin sulfate, and structural outcomes of pharmacologic treatments for strontium ranelate, recombinant human fibroblast growth factor 18, and glucosamine and chondroitin sulfate. Symptom outcomes of non-pharmacologic interventions were reported for: neuromuscular exercise, quadriceps strengthening, weight reduction and maintenance, TENS, therapeutic ultrasound, stepped care strategies, cognitive behavior therapy for sleep disturbance, acupuncture, gait modification, booster physical therapy, a web-based therapeutic exercise resource center for knee OA; hip physical therapy for hip OA; and joint protection and hand exercises for hand OA. Structure outcomes of non-pharmacologic interventions were reported for patellofemoral bracing.

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Section: Resultsmentioning

confidence: 99%

Osteoarthritis year in review 2015: clinical

Sharma

2016

Osteoarthritis and Cartilage

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“…Wise et al [54] did not report data on patellofemoral compartment in their study. However, using MOST data, Glass et al [22] recently reported that women have a greater prevalence of patellofemoral OA than men. Furthermore, in knees with patellofemoral OA, women reported greater severity of pain for all KL grades than men.…”

Section: Discussionmentioning

confidence: 99%

Are There Sex Differences in Knee Cartilage Composition and Walking Mechanics in Healthy and Osteoarthritis Populations?

Kumar

Souza

MacLeod

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Women are at a greater risk for knee osteoarthritis (OA), but reasons for this greater risk in women are not well understood. It may be possible that differences in cartilage composition and walking mechanics are related to greater OA risk in women.Questions/purposes (1) Do women have higher knee cartilage and meniscus T 1q than men in young healthy, middle-aged non-OA and OA populations? (2) Do women exhibit greater static and dynamic (during walking) knee loading than men in young healthy, middle-aged non-OA and OA populations? Methods Data were collected from three cohorts: (1) young active (\ 35 years) (20 men, 13 women); (2) middleaged (C 35 years) without OA (Kellgren-Lawrence [KL] grade \ 2) (43 men, 65 women); and (3) middle-aged with OA (KL [ 1) (18 men, 25 women). T 1q and T 2 relaxation times for cartilage in the medial knee, lateral knee, and patellofemoral compartments and medial and lateral menisci were quantified with 3.0-T MRI. A subset of the participants underwent three-dimensional motion capture during walking for calculation of peak knee flexion and adduction moments, flexion and adduction impulses, and peak adduction angle. Differences in MR, radiograph, and gait parameters between men and women were compared in the three groups separately using multivariate analysis of variance. Conclusions These data demonstrate differences in cartilage composition and gait mechanics between men and women in young healthy, middle-aged healthy, and OA cohorts. Considering the cross-sectional nature of the study, longitudinal research is needed to investigate if these differences in cartilage composition and walking mechanics are associated with a greater risk of lateral tibiofemoral or patellofemoral OA in women. Future studies should also investigate the relative risk of lateral versus medial patellofemoral cartilage degeneration risk in women compared with men. Level of Evidence Level III, retrospective study.

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“…Neurobiological mechanisms likely contribute to chronic pain in knee OA. It is now well‐established that central and peripheral sensitization are present in knee OA . Peripheral sensitization is defined as the facilitated response of nociceptive neurons located at the site of tissue injury or disease; it is limited to these nociceptors and will resolve as tissues heal and inflammation recedes.…”

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confidence: 99%

Duration of symptoms is associated with conditioned pain modulation and somatosensory measures in knee osteoarthritis

Foucher

Chmell

Courtney

2018

Journal Orthopaedic Research

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Impaired descending pain inhibition has been linked to chronic pain and poorer patient outcomes. Vibration perception threshold (VPT) has also been observed and linked to radiographic stage of OA. However, it is not known how duration of symptoms may influence these neurophysiological measures. Our purpose was to evaluate the relationship between duration of symptoms and conditioned pain modulation (CPM), a measure of descending pain inhibition, and VPT, and to determine whether these relationships differed in men and women seeking orthopedic care. We evaluated 18 men and 27 women with moderate to severe knee OA. We assessed CPM using a submaximal‐effort tourniquet test: Pressure pain threshold (PPT) at the symptomatic knee was evaluated before and after a noxious stimulus. CPM impairment was indicated by a ratio of pre‐to‐post stimulus PPT ≥1. VPT was assessed using a biothesiometer at the medial femoral condyle. We used chi‐square, t‐tests and Pearson correlations to address study questions. 72% of men, but only 44% of women had CPM impairment. Duration of symptoms was associated with CPM impairment in women (R = 0.566, p = 0.003) but not men (R = 0.366, p = 0.135). Duration of symptoms was also associated with VPT in both men (R = 0.580, p = 0.012) and women (R = 0.406, p = 0.039). These results suggest that longer duration of knee OA may predict more severe pain sensitization and that important sex differences exist in descending pain inhibition in people with chronic knee OA that may affect disease and course of treatment in male and female patients. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res

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Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

Cited by 106 publications

References 47 publications

Osteoarthritis year in review 2015: clinical

Osteoarthritis year in review 2015: clinical

Are There Sex Differences in Knee Cartilage Composition and Walking Mechanics in Healthy and Osteoarthritis Populations?

Duration of symptoms is associated with conditioned pain modulation and somatosensory measures in knee osteoarthritis

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