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Exploring different models of pain phenotypes and their association with pain worsening in people with early knee osteoarthritis: The MOST cohort study.

Authors
  • Neelapala, Y V Raghava1
  • Neogi, Tuhina2
  • Kumar, Deepak3
  • Jarraya, Mohamed4
  • Macedo, Luciana5
  • Kobsar, Dylan6
  • Hanna, Steven7
  • Frey-Law, Laura A8
  • Lewis, Cora E9
  • Nevitt, Michael10
  • Appleton, Tom11
  • Birmingham, Trevor12
  • Carlesso, Lisa C13
  • 1 School of Rehabilitation Science, McMaster University, Hamilton, Canada. Electronic address: [email protected]. , (Canada)
  • 2 Department of Medicine, Chobanian & Avedisian Boston University School of Medicine, United States. Electronic address: [email protected]. , (United States)
  • 3 Boston University College of Health & Rehabilitation Sciences, Sargent College, United States. Electronic address: [email protected]. , (United States)
  • 4 Department of Radiology, Massachusetts General Hospital, Harvard Medical School, United States. Electronic address: [email protected]. , (United States)
  • 5 School of Rehabilitation Science, McMaster University, Hamilton, Canada. Electronic address: [email protected]. , (Canada)
  • 6 Department of Kinesiology, McMaster University, Hamilton, Canada. Electronic address: [email protected]. , (Canada)
  • 7 Department of Health Research Methods, Faculty of Health Sciences, McMaster University, Hamilton, Canada. Electronic address: [email protected]. , (Canada)
  • 8 Department of Physical Therapy and Rehabilitation Science, University of Iowa, United States. Electronic address: [email protected]. , (United States)
  • 9 Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, United States. Electronic address: [email protected]. , (United States)
  • 10 Epidemiology & Biostatistics, University of California San Francisco, United States. Electronic address: [email protected]. , (United States)
  • 11 Department of Medicine and Physiology & Pharmacology, Western University, Canada. Electronic address: [email protected]. , (Canada)
  • 12 School of Physical Therapy, Western University, Canada. Electronic address: [email protected]. , (Canada)
  • 13 School of Rehabilitation Science, McMaster University, Hamilton, Canada. Electronic address: [email protected]. , (Canada)
Type
Published Article
Journal
Osteoarthritis and Cartilage
Publisher
Elsevier
Publication Date
Feb 01, 2024
Volume
32
Issue
2
Pages
210–219
Identifiers
DOI: 10.1016/j.joca.2023.09.003
PMID: 37709187
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To determine i) pain phenotypes (PP) in people with early-stage knee osteoarthritis (EKOA); ii) the longitudinal association between the phenotypes and pain worsening at two years. We studied participants with EKOA from the Multicenter Osteoarthritis Study defined as pain intensity ≤3/10, Kellgren and Lawrence grade ≤2, intermittent pain none to sometimes, and no constant pain. Two models of PP were explored. Model A included pressure pain thresholds, temporal summation, conditioned pain modulation, pain catastrophizing, sleep quality, depression, and widespread pain (WSP). In Model B, gait characteristics, quadriceps strength, comorbidities, and magnetic resonance imaging features were added to Model A. Latent Class Analysis was used to create phenotypes, and logistic regression was used to determine their association with pain worsening. 750 individuals (60% females), mean age [standard deviation (SD)]: 60.3 (9.4) were included in Model A and 333 individuals (60% females), mean age (SD): 59.4 (8.1) in Model B. 3-class and 4-class solutions were chosen for Model A and Model B. In Model A, the most "severe" phenotype was dominated by psychosocial factors, WSP, and measures of nervous system sensitization. Similarly in Model B, the Model A phenotype plus gait variables, quadriceps strength, and comorbidities were dominant. Surprisingly, none of the phenotypes in either model had a significant relationship with pain worsening. Phenotypes based upon various factors thought to be important for the pain experience were identified in those with EKOA but were not significantly related to pain worsening. These phenotypes require validation with clinically relevant endpoints. Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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