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Absence of pain in subjects with advanced radiographic knee osteoarthritis

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Authors
Son, Kyeong Min; Hong, Jeong Im; Kim, Dong-Hyun; Jang, Dae-Gyu; Crema, Michel D; Kim, Hyun Ah
Issue Date
2020-09-29
Publisher
BMC
Citation
BMC Musculoskeletal Disorders. 2020 Sep 29;21(1):640
Keywords
OsteoarthritisPainKnee
Abstract
Background
To investigate the frequency of pain among subjects with advanced radiographic knee osteoarthritis (OA) defined as Kellgren–Lawrence (KL) grade 4 and clinical features associated with pain.

Methods
Subjects from the Hallym Aging Study (HAS), the Korean National Health and Nutrition Examination Survey (KNHANES), and the Osteoarthritis Initiative (OAI) were included. Participants were asked knee-specific questions regarding the presence of knee pain. Clinical characteristics associated with the presence of pain were evaluated with multivariable logistic regression analysis.

Results
The study population consisted of 504, 10,152 and 4796 subjects from HAS, KNHANES, and OAI, respectively. KL grade 4 OA was identified in 9.3, 7.6, and 11.5% of subjects, while pain was absent in 23.5, 31.2, and 5.9% of subjects in KL grade 4 knee OA, respectively. After multivariable analysis, female gender showed a significant association with pain in the KNHANES group, while in the OAI group, younger age did. Advanced knee OA patients without pain did not differ from non-OA subjects in most items of SF-12 in both Korean and OAI subjects. Total WOMAC score was not significantly different between non-OA and advanced knee OA subjects without pain in the OAI.

Conclusions
Our study showed that a considerable number of subjects with KL grade 4 OA did not report pain. In patients whose pain arises from causes other than structural damage of the joint, therapeutic decision based on knee X-ray would lead to suboptimal result. In addition, treatment options focusing solely on cartilage engineering, should be viewed with caution.
ISSN
1471-2474
Language
English
URI
http://hdl.handle.net/10371/171111
DOI
doi.org/10.1186/s12891-020-03647-x
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College of Natural Sciences (자연과학대학)Dept. of Statistics (통계학과)Journal Papers (저널논문_통계학과)
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