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Pain-Related Risk Factors Among Radiologic Stages of Knee Osteoarthritis: Data From the Osteoarthritis Initiative
Zi-Jun He1, Shi-Lin Li2, Ji-Hua Zou3
1Affiliated Dongguan Hospital, Southern Medical University Dongguan People's Hospital, Dongguan, China.
Arthritis Care & Research
|January 18, 2023
Summary
Risk factors for knee osteoarthritis (OA) pain change as the disease progresses. Early stages show more factors influencing pain, while later stages have fewer, highlighting the need for tailored pain management strategies based on OA severity.
Area of Science:
- Orthopedics
- Rheumatology
- Pain Management
Background:
- Knee osteoarthritis (OA) is a leading cause of chronic pain and disability.
- Understanding the factors contributing to OA pain is crucial for effective management.
- Pain perception and its associated risk factors may differ across OA disease stages.
Purpose of the Study:
- To investigate how risk factors for knee pain vary across different stages of knee osteoarthritis (OA).
- To identify specific factors associated with pain severity at various radiographic grades of OA.
Main Methods:
- Utilized data from the Osteoarthritis Initiative, including Kellgren/Lawrence (K/L) grade and Numerical Rating Scale (NRS) pain scores.
- Classified pain severity into no pain, mild pain, and moderate/severe pain categories.
- Employed generalized ordinal logistic regression and heatmap visualization to analyze pain risk factors across K/L grades.
Main Results:
- Analyzed 4,446 subjects, identifying varying pain prevalence (no pain: 35.4%, mild pain: 25.6%, moderate/severe pain: 39.0%).
- In early OA stages, knee injury history, diabetes, depression, NSAID use, and valgus alignment were linked to increased pain; older age and stronger quadriceps were linked to less pain.
- As OA progressed to end-stage, only age and quadriceps muscle force remained significant pain predictors.
Conclusions:
- Numerous factors contribute to knee OA pain, but their significance diminishes as the disease advances.
- Pain management strategies for knee OA should be individualized based on the radiographic severity of the disease.
- The decreasing number of significant risk factors in later OA stages suggests a potential shift in pain mechanisms.
