Association Between Knee Load and Pain: Within‐Patient, Between‐Knees, Case–Control Study in Patients With Knee Osteoarthritis

Birmingham, Trevor B.; Marriott, Kendal; Leitch, Kristyn M.; Moyer, R.; Lorbergs, Amanda L.; Walton, Dave; Willits, Kevin; Litchfield, Robert; Getgood, Alan; Fowler, Peter; Giffin, J. Robert

doi:10.1002/acr.23704

Cited by 26 publications

(20 citation statements)

References 15 publications

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“…Using this method, in 2 large knee OA cohorts, researchers showed that knee pain was strongly associated with radiographic tibiofemoral OA (11). Similar approaches have since been used to better understand various knee-specific determinants of pain in knee OA (12,13), and such approaches would be well-suited to evaluating joint-level determinants of anterior knee pain.…”

Section: Introductionmentioning

confidence: 99%

Relation of Patellofemoral Joint Alignment, Morphology, and Radiographic Osteoarthritis to Frequent Anterior Knee Pain: Data from the Multicenter Osteoarthritis Study

Macri

Neogi

Tolstykh

et al. 2020

Arthritis Care & Research

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Objective. Patellofemoral (PF) alignment and trochlear morphology are associated with PF osteoarthritis (OA) and knee pain, but whether they are associated with localized anterior knee pain is unknown, which is believed to be a symptom specific to PF joint pathology. We therefore aimed to evaluate the relation of PF alignment and morphology, as well as PFOA and tibiofemoral OA, to anterior knee pain.Methods. The Multicenter Osteoarthritis Study is a cohort study of individuals with, or at risk for, knee OA. We evaluated cross-sectional associations of PF alignment, trochlear morphology, and PF and tibiofemoral radiographic OA, with localized anterior knee pain (defined with a pain map). We used 2 approaches: a within-person kneematched evaluation of participants with unilateral anterior knee pain (conditional logistic regression), and a cohort approach comparing those with anterior knee pain to those without (binomial regression).Results. With the within-person knee-matched approach (n = 110; 64% women, mean age 70 years, body mass index [BMI] 30.9), PF alignment, morphology, and tibiofemoral OA were not associated with unilateral anterior knee pain. Radiographic PFOA was associated with pain, odds ratio 5.3 (95% confidence interval [95% CI] 1.6-18.3). Using the cohort approach (n = 1,818; 7% of knees with anterior knee pain, 59% women, mean age 68 years, BMI 30.4), results were similar: only PFOA was associated with pain, with a prevalence ratio of 2.2 (95% CI 1.4-3.4).Conclusion. PF alignment and trochlear morphology were not associated with anterior knee pain in individuals with, or at risk for, knee OA. Radiographic PFOA, however, was associated with pain, suggesting that features of OA, more so than mechanical features, may contribute to localized symptoms.

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Section: Introductionmentioning

confidence: 99%

Relation of Patellofemoral Joint Alignment, Morphology, and Radiographic Osteoarthritis to Frequent Anterior Knee Pain: Data from the Multicenter Osteoarthritis Study

Macri

Neogi

Tolstykh

et al. 2020

Arthritis Care & Research

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“…Two studies in the past year used a stimulus-response model, highlighted for its relevance to OA by Andriacchi in 2012 75 , to investigate how pain after a bout of walking was related to jointlevel biomechanics. Birmingham et al examined KAM peaks and impulses after a 6-min walking bout in 256 individuals with radiographic and symptomatic medial compartment knee OA, but who had discordant pain ratings between knees 76 . Higher KAM peaks and impulses were related to a greater risk of pain during the walking bout (OR ¼ 2.4, 95% CI: 1.8e3.3 and 6.6, 95% CI: 3.5e12.7, respectively), and this relationship was most prominent in the highest knee load quartile.…”

Section: Pain and Mechanicsmentioning

confidence: 99%

Osteoarthritis year in review 2019: mechanics

Hunt

Charlton

Esculier

2020

Osteoarthritis and Cartilage

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Mechanics play a critical e but not sole e role in the pathogenesis of osteoarthritis, and recent research has highlighted how mechanical constructs are relevant at the cellular, joint, and whole-body level related to osteoarthritis outcomes. This review examined papers from April 2018 to April 2019 that reported on the role of mechanics in osteoarthritis etiology, with a particular emphasis on studies that focused on the interaction between movement and tissue biomechanics with other clinical outcomes relevant to the pathophysiology of osteoarthritis. Studies were grouped by themes that were particularly prevalent from the past year. Results of the search highlighted the large exposure of knee-related research relative to other body areas, as well as studies utilizing laboratory-based motion capture technology. New research from this past year highlighted the important role that rate of exerted loads and rate of muscle force development e rather than simply force capacity (strength) e have in OA etiology and treatment. Further, the role of muscle activation patterns in functional and structural aspects of joint health has received much interest, though findings remain equivocal. Finally, new research has identified potential mechanical outcome measures that may be related to osteoarthritis disease progression. Future research should continue to combine knowledge of mechanics with other relevant research techniques, and to identify mechanical markers of joint health and structural and functional disease progression that are needed to best inform disease prevention, monitoring, and treatment.

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“…Birmingham и соавт. [37] изучили симптоматику у 265 больных ОА коленного сустава и отметили связь между выраженностью нагрузки и интенсивностью боли в суставах. Заметную роль нарушений биомеханики в развитии клиники и прогрессировании ОА коленного сустава показывают результаты масштабных исследований MOST (многоцентровое исследование ОА) и «Инициатива остеоартрита».…”

Section: фенотип скелетно-мышечной боли связанный с движением («мехаunclassified

Musculoskeletal pain: determination of clinical phenotypes and the rational treatment approach

Каратеев¹

2019

Alʹm. klin. med.

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Personalized treatment is one of the basic principles of modern medicine. When administering a treatment, one should consider individual patient characteristics, comorbidities and, what is most important, the prevailing symptoms, as well as the clinical phenotype of a disease. This is directly related to chronic musculoskeletal pain (MSP), which occurs with underlying most prevalent joint and vertebral disorders. At present, MSP is considered to be an independent clinical syndrome.Predominant mechanisms of MSP pathophysiology allow for determination of its special phenotypes: “inflammatory”, “mechanical”, related to enthesopathy and central sensitization. Treatment strategies for MSP phenotypes should obviously be differentiated and based on a tailored and pathophysiologically sound of medical agents and non-medical measures with different mechanisms of pharmacological effects. Effective treatment of the “inflammatory” phenotype requires the use of non-steroidal anti-inflammatory drugs, topical glucocorticoids, disease modifying anti-inflammatory agents. The “mechanical” phenotype necessitates the correction of biomechanical abnormalities, the use of hyaluronic acid containing agents, whereas the “enthesopathic” phenotype is treated with local therapy. Treatment of the phenotype with central sensitization is performed with agents effective for neuropathic pain (anticonvulsants, anti-depressants).

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Association Between Knee Load and Pain: Within‐Patient, Between‐Knees, Case–Control Study in Patients With Knee Osteoarthritis

Abstract: When between-patient confounding is minimized, there is a strong association between medial knee load and increased knee pain during walking. This article is protected by copyright. All rights reserved.

Cited by 26 publications

References 15 publications

Relation of Patellofemoral Joint Alignment, Morphology, and Radiographic Osteoarthritis to Frequent Anterior Knee Pain: Data from the Multicenter Osteoarthritis Study

Relation of Patellofemoral Joint Alignment, Morphology, and Radiographic Osteoarthritis to Frequent Anterior Knee Pain: Data from the Multicenter Osteoarthritis Study

Osteoarthritis year in review 2019: mechanics

Musculoskeletal pain: determination of clinical phenotypes and the rational treatment approach

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