Trajectories and risk profiles of pain in persons with radiographic, symptomatic knee osteoarthritis: data from the osteoarthritis initiative

被引:165
|
作者
Collins, J. E. [1 ,3 ]
Katz, J. N. [1 ,2 ]
Dervan, E. E. [1 ]
Losina, E. [1 ,3 ]
机构
[1] Harvard Univ, Brigham & Womens Hosp, Sch Med, Orthopaed & Arthrit Ctr Outcomes Res,Dept Orthope, Boston, MA 02115 USA
[2] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Rheumatol Allergy & Immunol, Boston, MA 02115 USA
[3] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA USA
基金
美国国家卫生研究院;
关键词
Osteoarthritis; Pain; Trajectories; Group-based trajectory modeling; Cohort study; FEAR-AVOIDANCE MODEL; CHRONIC MUSCULOSKELETAL PAIN; QUALITY-OF-LIFE; OLDER-ADULTS; HIP OSTEOARTHRITIS; SAS PROCEDURE; DISEASE; DEPRESSION; ARTHRITIS; SEVERITY;
D O I
10.1016/j.joca.2014.03.009
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Little is known about the temporal evolution of pain severity in persons with knee osteo-arthritis (OA). We sought to describe the pain trajectory over 6 years in a cohort of subjects with radiographic, symptomatic knee OA. Methods: We used data from the Osteoarthritis Initiative (OAI), a multi-center, longitudinal study of subjects with diagnosed radiographic evidence of knee OA. Pain was Assessed at baseline and annually for 6 years. Our analysis cohort included subjects with symptomatic knee OA at baseline, defined as baseline Kellgren-Lawrence (KL) score >= 2 with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score >0. We used group-based trajectory modeling to identify distinct patterns of pain progression over a 6-year follow-up. Factors examined included sex, race, education, comorbidities, age, body mass index (BMI), alignment, KL grade, and depression. Results: We used data from 1753 OAI participants with symptomatic knee OA. Mean baseline WOMAC pain score was 26.5 (0-100, 100=worst) with standard deviation (SD) 19. Group-based trajectory modeling identified five distinct pain trajectories; baseline pain scores for each ranged from 15 to 62. None of the trajectories exhibited substantial worsening. One fifth of subjects in the two trajectories with the greatest pain underwent total knee replacement (TKR) over follow-up. Higher KL grade, obesity, depression, medical comorbidities, female sex, non-white race, lower education, and younger age were associated with trajectories characterized by greater pain. Conclusion: We found that knee pain changes little, on average, over 6 years in most subjects. These observations suggest knee OA is characterized by persistent rather than inexorably worsening symptoms. (C) 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:622 / 630
页数:9
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