Abstract
BackgroundMany people with radiographic knee osteoarthritis (RKOA) do not present with pain. It is suspected that such persons tend toward lower body mass index (BMI). The purpose of the study was to explore the relationship between BMI and knee pain among persons with RKOA.MethodsSubjects in the Clearwater Osteoarthritis Study with RKOA (N = 576) were classified as reporting knee pain (Pain) or no knee pain (No Pain). WHO-classified BMI categories were compared by pain status. Odds ratios were calculated for the four elevated BMI groups, with the normal BMI group as the reference group. Elevated BMI was the risk factor, and knee pain status was the outcome factor.ResultsPain subjects presented with a higher mean BMI (30.4 kg/m2) compared with No Pain subjects (27.5 kg/m2) (p < 0.0001). Unadjusted and adjusted odds ratios demonstrated a positive association between BMI group and pain for each successive elevated BMI category. Adjusted odds ratios ranged from 1.6 for the Pre-obese group (p < 0.05) to 7.5 for the Obese III group (p < 0.0001).ConclusionAmong subjects with RKOA, those presenting with an elevated BMI had a greater likelihood of knee pain compared to subjects with a normal BMI, and this chance rose with each successive elevated BMI category. As BMI is a modifiable risk factor, longitudinal research is needed to confirm these findings and elucidate the mechanisms underlying this relationship.
Highlights
Many people with radiographic knee osteoarthritis (RKOA) do not present with pain
Our current study aims to help clarify these findings by reporting odds ratios to further quantify the relationship between pain and body mass index (BMI) among persons with RKOA
To our knowledge, the relationship among BMI, RKOA and knee pain has not been previously reported in terms of odds ratios
Summary
Many people with radiographic knee osteoarthritis (RKOA) do not present with pain. The purpose of the study was to explore the relationship between BMI and knee pain among persons with RKOA. Symptomatic knee OA is a major cause of physical disability afflicting older persons, due to pain, stiffness, and joint instability [2,3]. While the cause of radiographic knee OA (RKOA) remains unclear, it has been associated with various risk factors, such as advancing age, female gender, genetic predisposition, prior knee injury, certain occupations, biomechanical gait and alignment defects, and obesity. Epidemiological studies have linked RKOA-related knee pain with increasing radiographic severity, bone marrow lesions, bone ulceration, quadriceps weakness, and psychological factors [9]. A clear profile of those who experience pain and those who do not remains to be (page number not for citation purposes)
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