WITHDRAWN: Neuropathic Pain in Patients with Knee Osteoarthritis: Relation with Comorbidities and Functional Status

Abstract

Objectives: The aim of this study was to evaluate the prevalence of neuropathic pain components of knee osteoarthritis (OA) patients and to identify the relation between associated neuropathic pain and comorbidities, pain intensity, function, and radiographic severity of knee OA. Methods: This cross-sectional study enrolled patients with knee OA (ACR criteria 1986). Visual Analog Scale (VAS), DN4 questionnaires were performed for each patient. A score of DN4≥4/10 was classified as diagnostic for neuropathic pain. Functional impairment was estimated using the short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-PS) ad radiographs were rated using the Kellgren Lawrence (KL). Results: We recruited 101 patients with a sex ratio was 0.1. The mean age was 65.5±10.8 years [41-95]. The mean duration of symptoms was 3.5 years. At least one comorbidity was revealed for 88.1% of patients. Mean VAS pain was 6.5±1.69. The mean DN4 score was 4.8± 2.4. The prevalence of NP (DN4≥4) was detected in 68.3%. The most frequently described NP characteristic was the sensation of burning (74%). The mean KOOS-PS score was 46.4±19.2. Based on KL grading, 78.2% of OA were classified grade III-IV. Female gender, number of comorbidities, bilateral knee OA, mean VAS pain, and mean KOOS-PS score were significantly higher in the neuropathic pain group when compared to the group without neuropathic (respectively: p=0.01,p=0.04, p=0.017, p=0.00, p=0.00). In multivariate regression, KOOS-PS and bilateral knee OA were independently associated with NP. Conclusion: Our results highlight the frequent NP in patients with knee OA (68.3%) and its relation with function and comorbidities.

Neuropathic Pain Associated With First Metatarsophalangeal Joint Osteoarthritis: Frequency and Associated Factors

“…We observed several person-level but few foot-level differences between participants with and those without neuropathic pain. Those with neuropathic pain had worse general health (demonstrated by lower SF-12 scores) and greater pain severity, which is consistent with previous reports related to neuropathic pain in individuals with knee OA using a range of health-related quality of life measures (11,13,14) and pain assessment tools (7,8,10,15). Interestingly, we found that although pain severity at rest was higher in those with neuropathic pain, pain during walking was not.…”

“…The presence of neuropathic symptoms increases the individual burden of knee OA, as it is associated with more severe pain ( 7 , 8 , 9 , 10 ), greater impairment in physical function ( 9 , 10 , 11 , 12 , 13 ), worse quality of life ( 10 , 11 , 13 , 14 ), and poorer sleep quality ( 10 ). Several person‐level factors are associated with neuropathic pain in individuals with knee OA, including increased age ( 13 ), higher body mass index (BMI) ( 13 ), female sex ( 8 ), multiple comorbidities ( 8 ), pain at multiple sites ( 7 , 12 ), referred pain ( 7 ), and hyperalgesia ( 9 ).…”

“…The presence of neuropathic symptoms increases the individual burden of knee OA, as it is associated with more severe pain ( 7 , 8 , 9 , 10 ), greater impairment in physical function ( 9 , 10 , 11 , 12 , 13 ), worse quality of life ( 10 , 11 , 13 , 14 ), and poorer sleep quality ( 10 ). Several person‐level factors are associated with neuropathic pain in individuals with knee OA, including increased age ( 13 ), higher body mass index (BMI) ( 13 ), female sex ( 8 ), multiple comorbidities ( 8 ), pain at multiple sites ( 7 , 12 ), referred pain ( 7 ), and hyperalgesia ( 9 ). Knee joint–specific correlations with neuropathic pain include meniscal lesions ( 15 ) and prior surgery ( 10 ), although reported associations with radiographic severity are inconsistent ( 12 , 13 , 16 ).…”

Eumycotic mycetoma involving the right foot: A new Tunisian case

“… 7 , 10 Some sinuses heal with scarring while new sinuses emerge elsewhere, leading to gruesome deformity of the affected limb. 16 , 18 , 19 , 20 , 21 Despite its several worrisome impacts, simple mentioning of mycetoma still leads astonishment. This is probably owing to poor awareness of its existence as a consequence of low identification and reporting as it is not a reportable disease.…”

“…The causative organisms trigger the formation of grains that may be discharged into the skin surface through multiple sinuses 7,10 . Some sinuses heal with scarring while new sinuses emerge elsewhere, leading to gruesome deformity of the affected limb 16,18‐21 . Despite its several worrisome impacts, simple mentioning of mycetoma still leads astonishment.…”