Osteoarthritis And Hispanics: A Comparative Analysis Of Pain, Function, And Pain Catastrophizing

Abstract

BACKGROUND: Osteoarthritis (OA) of the knee afflicts over 54 million Americans including 3.1 million Hispanics. Several studies provide treatment guidelines for OA in a stepwise fashion, beginning with physical therapy and only intensifying treatment after 6 months of therapy or identification of radiographic severity (K-L grade of 2 or greater). This approach correlates well with worsening patient symptoms in the non-Hispanic Caucasian individual (NHWP)4. To date, no association between pain, function, and K-L grade has been established in the Hispanic population. Additionally, no comparative analysis of pain catastrophizing for knee OA in Hispanic persons and NHWP has been reported. PURPOSE: Characterize Hispanic patients with knee OA on basis of pain (VAS), function (WOMAC), and radiographic severity (K-L grade) and compare findings to those of NHWP. METHODS: With IRB approval, we conducted a convenient sampling of 90 patients. Patients were considered if they presented with knee pain and were given a primary diagnosis of OA. Patients who met our inclusion criteria were administered PCS, WOMAC, VAS and demographic questionnaires. K-L grade was determined using WBAPE radiographs. RESULTS: 75 patients were analyzed. 54 Hispanic (30% M: F), 25 NHWP (36% M: F). On average, Hispanic patients report greater pain scores than non-Hispanics (p < 0.05). Additionally, Hispanic patients reported greater functional impairment (p < 0.05). There was minimal difference in pain catastrophizing scores between Hispanic (10.9 +/- 10.7 and Caucasian patients (6.5 +/- 5.6). The differences in average K-L grade were insignificant 1.97 and 2.06, respectively. The correlation between VAS and K-L as well as WOMAC and K-L in Hispanics was weak (R < 0.7). CONCLUSION: Hispanics demonstrated greater pain scores with greater functional impairment without demonstrating significantly different scores in pain catastrophizing. These same patients demonstrated a weak correlation between pain, function, and radiographic score, questioning the utility of K-L grade in management of these patients.