AB0604 FACTORS ASSOCIATED WITH PAIN IN EARLY KNEE OSTEOARTHRITIS (PRELIMINARY DATA)
Authors: Alekseeva L. , Taskina E. , Kashevarova N. , Telyshev K. , Strebkova E. , Anikin S. , Sharapova E. , Lila A. 
Published: May 2021

Background:

Objectives:

To identify factors associated with pain in patients with early knee osteoarthritis fulfilling ESKOA criteria [1].

Methods:

50 patients (46 women (92%); 4 men (8%)) fulfilling ESKOA criteria were enrolled in the trial, every participant signed up the consent form. Median age of patients was 47 ± 8 yrs (36 – 63 yrs), body mass index (BMI) was 28.5 ± 4.9 kg/m2 (40% of patients had obesity). Every patient, after signing the standard informed consent form, was addressed to a physician, who would fill in an individual case report form (CRF), including anthropometric parameters, history of OA, comorbidities and physical examination data. Knee pain was also assessed with the use of visual analog scale (VAS). All participants underwent knee X-ray according to the standardized fixed flexion protocol with the use of positioning frame [2].

Results:

Most of the patients (70%) were between the ages of 35 and 50 and only 15 of them (30%) were older than 50 years. Median knee pain duration was found to be 16 (12-20) weeks, intensity of VAS – knee pain was 46 mm (42-50). Median number of episodes of knee pain (in the last 6 months) was 3 (2-6); 30 participants (60%) had episodes of knee pain lasting less than a week, 8 of them (6%) had pain lasting for around a week, 12 of them (24%) had episodes of pain lasting more than one week. In most patients (74%) pain relieved with time, without any additional therapy. Most of the patients had episodes of knee pain linked to increased overload (48 (96%)), when squatting (41 (82%)), most of the patients also reported pain when climbing up and down the stairs (80%) and short joint stiffness when starting movement (76%). Knee pain after sitting was reported in 54% of cases and 20 participants (40%) also reported some walking limitations due to knee discomfort.

Knee X-ray revealed that most of the patients had I Kellgren&Lawrence (K&L) stage knee OA (picture 1). All the included participants had ESR (7 (5-10 mm/hr)) and CRP (1.24 (0.8-2.2 mg/l)) within normal range.

Picture 1 – Radiological knee OA stage (K&L) distribution in the study group

In the Spearman correlation analysis, we have estimated the factors, which may be associated with more severe pain in patients with early knee OA fulfilling the ESKOA criteria. We found out that higher BMI (r=0.38, р=0.02), presence of metabolic syndrome (r=0.37, р=0.008) and hypertension (r=0.29, р=0.04), as well as walking limitations (r=0.33, р=0.008) are associated with knee pain.

Conclusion:

The use of ESKOA criteria in patients with short duration of knee pain can facilitate diagnosis of osteoarthritis on an early stage. In addition, the acquired data show that timely diagnosis and correction of certain components of metabolic syndrome may be beneficial for the course of knee pain intensity in patients with early knee OA, further continuation of this trial is necessary.

References:

[1]Migliore A et al. Rheumatol Int. 2017 Aug;37(8):1227-1236.

[2]Mazzuca SA et al. Osteoarthritis Cartilage. 2008 Dec;16(12):1555-9.

Disclosure of Interests:

None declared.