4.3 Article

Short-term pain trajectories in patients with knee osteoarthritis

Journal

INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES
Volume 25, Issue 3, Pages 281-294

Publisher

WILEY
DOI: 10.1111/1756-185X.14267

Keywords

knee joint osteoarthritis pain; short-term pain; trajectory

Categories

Funding

  1. National Health and Medical Research Council [APP1021655]

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This study aimed to determine whether individuals with a previous history of knee osteoarthritis (KOA) pain fluctuations have distinct pain trajectories over a 90-day period and examine the associations between baseline characteristics and pain trajectories. The results revealed that persons with KOA exhibited unique short-term pain trajectories over 90 days, with baseline characteristics associated with each trajectory.
Aim It is unknown if pain in knee osteoarthritis (KOA) follows distinct patterns over the short term. Therefore, the aim of this study was to identify whether persons with a previous history of KOA pain fluctuations have distinct trajectories of pain over 90 days and to examine associations between baseline characteristics and pain trajectories. Method People with a previous history of KOA were selected from a web-based longitudinal study. Baseline variables were sex, age, being obese/overweight, years of KOA, knee injury, knee buckling, satisfactory Lubben Social Support Score, pain and stress scales, Intermittent Constant Osteoarthritis Pain Score (ICOAP), medication use, and physical activity. Participants completed a Knee Injury and Osteoarthritis Outcomes Score (KOOS) pain subscale (KOOS-p, rated 0 = extreme to 100 = no knee problems) at 10-day intervals for 90 days. Short-term KOOS-p trajectories were identified using latent growth mixture modeling and the baseline risk factors for these pain trajectories were examined. Results Participants (n = 313) had a mean age of 62.2 (SD +/- 8.1) years and and a body mass index of 29.8 (SD +/- 6.6) kg/m(2). The three-class latent growth mixture modeling quadratic model with best fit indices was chosen (based on lowest sample-size-adjusted Bayesian Information Criterion, high probability of belonging, interpretability). Three distinct pain trajectory clusters (over 90 days) were identified: low-moderate pain at baseline with large improvement (n = 11), minimal change in pain over 90 days (n = 248), and moderate-high pain with worsening (n = 46). Higher ICOAP (intermittent scale), perceived stress, negative affect score, and knee buckling at baseline were associated with a worse knee pain trajectory (P < 0.05). Conclusions Persons with KOA showed unique short-term pain trajectories over 90 days, with distinct characteristics at baseline associated with each trajectory.

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