Factors for Pain in Patients With Different Grades of Knee Osteoarthritis

Abstract

Objective. Discordance between having pain and radiologic osteoarthritis (OA) is a well-established fact. It is suggested that this particularly applies to the less severe grades of OA. However, some people with a Kellgren/Lawrence (K/L) grade of 3 or 4 for OA are without pain. This study aimed to identify factors and differences in the factors associated with pain in persons with different grades of knee OA. Methods. We stratified the knees of more than 5,000 participants of a population-based cohort study, the Rotterdam Study, based on the grade of knee OA. Multivariate generalized estimating equation analysis was used to analyze the association with knee pain. We tested several factors not directly related to structural damage of the knee. Results. As expected, an increasing percentage of participants did not report pain with decreasing severity of knee OA: 25.8% for K/L grade 3 or 4 and 84.5% for no knee OA. Being a woman, having widespread pain, reporting general health symptoms, familial OA, and morning stiffness are factors for knee pain, but not specific for a particular grade of radiographic knee OA. Depression and hip OA showed significant interactions with the grade of OA being a factor for knee pain in knees without OA (K/L grade 0), but not in knees with OA. In addition, increasing age is protective for reporting pain in general. Conclusion. Several factors are associated with knee pain, but are not specific for a grade of radiographic knee OA. Two factors were associated with knee pain in the knee without signs of OA.

Relationship between decreased lower extremity muscle mass and knee pain severity in both the general population and patients with knee osteoarthritis: Findings from the KNHANES V 1-2

“…However, the results were somewhat controversial, and varied by participant ethnicity and other included variables. One population-based cohort study including more than 5,000 participants showed that high BMI was not associated with knee pain [34]. In our study, obesity was not related to knee pain in either the general population or RKOA participants.…”

“…This result was consistent with previous studies. Schiphof et al, reporting on data from the Rotterdam population-based cohort study, showed that subjects with stiffness had a higher risk for knee pain (OR 1.88, 95% CI 1.48–2.39) in [34]. They speculated that stiffness was correlated with OA prevalence, because stiffness is an OA symptom.…”

“…Several studies have investigated the relationship between thigh muscle mass and knee pain [15, 16, 37, 38]. Those studies evaluated muscle mass using computed tomography and magnetic resonance imaging.…”

“…Numerous factors, such as age, morning knee stiffness, high BMI, temporal patterns of knee pain, depression, and anxiety, have been proposed to explain this discordance [4, 34]. However, the causes remain unknown.…”

Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

“…However, that particular KL grade comparison was likely underpowered. In a study conducted in the Netherlands, Schiphof et al found being female was a significant risk factor for knee pain, but the increased risk for women was not KL grade specific 29 . In a study involving adults scheduled for knee replacement surgery, women were found to have greater pain intensity during movement and pain sensitivity compared with men 6 .…”