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2000
Volume 21, Issue 5
  • ISSN: 1573-3971
  • E-ISSN: 1875-6360

Abstract

Objectives

The aim of this study was to evaluate the prevalence of neuropathic pain components in knee osteoarthritis (OA) patients and to identify the relation between associated neuropathic pain and comorbidities, pain intensity, function, and radiographic severity of knee OA.

Methods

This cross-sectional study enrolled patients with knee OA (ACR criteria 1986). Visual Analog Scale (VAS) and DN4 questionnaires were performed for each patient. A score of DN4≥4/10 was classified as diagnostic for neuropathic pain. Functional impairment was estimated using the short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-PS) and radiographs were rated using the Kellgren Lawrence (KL).

Results

We recruited 101 patients with a sex ratio was 0.1. The mean age was 65.5 ± 10.8 years. The mean duration of symptoms was 3.5 years. At least one comorbidity was revealed for 88.1% of patients. Mean VAS pain was 6.5 ± 1.69. The mean DN4 score was 4.8 ± 2.4. The prevalence of NP (DN4≥4) was detected at 68.3%. The most frequently described NP characteristic was the sensation of burning (74%). The mean KOOS-PS score was 46.4 ± 19.2. Based on KL grading, 78.2% of OA were classified as grade III-IV.

Female gender, number of comorbidities, bilateral knee OA, mean VAS pain, and mean KOOS-PS score were significantly higher in the neuropathic pain group when compared to the group without neuropathic (respectively: = 0.01, = 0.04, = 0.017, = 0.00, = 0.00). In multivariate regression, KOOS-PS and bilateral knee OA were independently associated with NP.

Conclusion

Our results highlight the frequent NP in patients with knee OA (68.3%) and its relation with function and comorbidities.

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2025-11-28
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References

  1. HeijinkA. GomollA.H. MadryH. Biomechanical considerations in the pathogenesis of osteoarthritis of the knee.Knee Surg. Sports Traumatol. Arthrosc.201220423435
    [Google Scholar]
  2. FelsonD.T. The sources of pain in knee osteoarthritis.Curr. Opin. Rheumatol.200517562462810.1097/01.bor.0000172800.49120.97 16093843
    [Google Scholar]
  3. BedsonJ. CroftP.R. The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature.BMC Musculoskelet. Disord.20089111610.1186/1471‑2474‑9‑116 18764949
    [Google Scholar]
  4. FrenchH.P. SmartK.M. DoyleF. Prevalence of neuropathic pain in knee or hip osteoarthritis: A systematic review and meta-analysis.Semin. Arthritis Rheum.20174711810.1016/j.semarthrit.2017.02.008 28320529
    [Google Scholar]
  5. TrouvinA-P. PerrotS. Pain in osteoarthritis. Implications for optimal management.Joint Bone Spine201885442943410.1016/j.jbspin.2017.08.002 28889010
    [Google Scholar]
  6. TerryE.L. BookerS.Q. CardosoJ.S. Neuropathic-like pain symptoms in a community-dwelling sample with or at risk for knee osteoarthritis.Pain Med.202021112513710.1093/pm/pnz112 31150093
    [Google Scholar]
  7. BennettM.I. AttalN. BackonjaM.M. Using screening tools to identify neuropathic pain.Pain2007127319920310.1016/j.pain.2006.10.034 17182186
    [Google Scholar]
  8. AltmanR. AschE. BlochD. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee.Arthritis Rheum.19862981039104910.1002/art.1780290816 3741515
    [Google Scholar]
  9. PerruccioA.V. LohmanderS.L. The development of a short measure of physical function for knee OA KOOS-physical function shortform (KOOS-PS) - an OARSI/OMERACT initiative.Osteoarthritis Cartilage200816554255010.1016/j.joca.2007.12.014 18294869
    [Google Scholar]
  10. KellgrenJ.H. LawrenceJ.S. Radiological assessment of osteo-arthrosis.Ann. Rheum. Dis.195716494502 13498604
    [Google Scholar]
  11. TerkawiA.S. AbolkhairA. DidierB. Development and validation of Arabic version of the douleur neuropathique 4 questionnaire.Saudi J. Anaesth.2017115Suppl. 1S31S3910.4103/sja.SJA_97_17 28616002
    [Google Scholar]
  12. NeogiT. The epidemiology and impact of pain in osteoarthritis.Osteoarthr Cartil OARS Osteoarthr Res Soc20132191145115310.1016/j.joca.2013.03.018 23973124
    [Google Scholar]
  13. HochmanJ.R. GaglieseL. DavisA.M. HawkerG.A. Neuropathic pain symptoms in a community knee OA cohort.Osteoarthritis Cartilage201119664765410.1016/j.joca.2011.03.007 21440077
    [Google Scholar]
  14. ThakurM. DickensonA.H. BaronR. Osteoarthritis pain: Nociceptive or neuropathic?Nat. Rev. Rheumatol.201410637438010.1038/nrrheum.2014.47 24686507
    [Google Scholar]
  15. MathiesonS. MaherC.G. TerweeC.B. Folly de CamposT. LinC-W.C. Neuropathic pain screening questionnaires have limited measurement properties. A systematic review.J. Clin. Epidemiol.201568895796610.1016/j.jclinepi.2015.03.010 25895961
    [Google Scholar]
  16. Oteo-ÁlvaroÁ. Ruiz-IbánM.A. MiguensX. SternA. VilloriaJ. Sánchez-MagroI. High prevalence of neuropathic pain features in patients with knee osteoarthritis: A cross-sectional study.Pain Pract.201515761862610.1111/papr.12220 24750662
    [Google Scholar]
  17. MoretonB.J. TewV. das Nair R, Wheeler M, Walsh DA, Lincoln NB. Pain phenotype in patients with knee osteoarthritis: Classification and measurement properties of painDETECT and self-report Leeds assessment of neuropathic symptoms and signs scale in a cross-sectional study.Arthritis Care Res. (Hoboken)201567451952810.1002/acr.22431 25155472
    [Google Scholar]
  18. GölgeU.H. ŞenH.M. KuyucuE. Investigation of knee pain in osteoarthritic and neuropathic pain awareness.Acta Orthop. Belg.2015814639646 26790785
    [Google Scholar]
  19. NarayanR. ThabahM. PoduvalM. Neuropathic pain among patients with primary knee osteoarthritis: Results of a cross-sectional study from a tertiary care center in Southern India.Indian J. Rheumatol.201712313210.4103/injr.injr_90_16
    [Google Scholar]
  20. BlikmanT. RienstraW. van RaayJ.J.A.M. Neuropathic-like symptoms and the association with joint-specific function and quality of life in patients with hip and knee osteoarthritis.PLoS One2018136e019916510.1371/journal.pone.0199165 29902245
    [Google Scholar]
  21. AşkınA. ÖzkanA. TosunA. DemirdalÜ.S. İsnaçF. Quality of life and functional capacity are adversely affected in osteoarthritis patients with neuropathic pain.Kaohsiung J. Med. Sci.201733315215810.1016/j.kjms.2016.12.007 28254118
    [Google Scholar]
  22. PolatC.S. DoğanA. ÖzcanS.D. KöseoğluB.F. KoçerA.S. Is there a possible neuropathic pain component in knee osteoarthritis?Arch. Rheumatol.201732433333810.5606/ArchRheumatol.2017.6006 29901006
    [Google Scholar]
  23. RadwanA. BoraiA. Neuropathic pain in Egyptian patients with primary knee osteoarthritis: Relationship with functional status and radiological severity.Egypt. Rheumatol.201941426126410.1016/j.ejr.2018.12.005
    [Google Scholar]
  24. HunterD.J. McDougallJ.J. KeefeF.J. The symptoms of osteoarthritis and the genesis of pain.Rheum. Dis. Clin. North Am.200834362364310.1016/j.rdc.2008.05.004 18687276
    [Google Scholar]
  25. HannanM.T. FelsonD.T. PincusT. Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee.J. Rheumatol.200027615131517 10852280
    [Google Scholar]
  26. KosekE. OrdebergG. Abnormalities of somatosensory perception in patients with painful osteoarthritis normalize following successful treatment.Eur. J. Pain20004322923810.1053/eujp.2000.0175 10985866
    [Google Scholar]
  27. BouhassiraD. AttalN. AlchaarH. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4).Pain20051142936
    [Google Scholar]
  28. GlassN. SegalN.A. SlukaK.A. Examining sex differences in knee pain: The multicenter osteoarthritis study.Osteoarthritis Cartilage20142281100110610.1016/j.joca.2014.06.030 24999111
    [Google Scholar]
  29. FernandesG.S. ValdesA.M. WalshD.A. ZhangW. DohertyM. Neuropathic-like knee pain and associated risk factors: A cross-sectional study in a UK community sample.Arthritis Res. Ther.201820121510.1186/s13075‑018‑1717‑6 30261907
    [Google Scholar]
  30. MossP. BensonH.A.E. WillR. WrightA. Patients with knee osteoarthritis who score highly on the pain detect questionnaire present with multi-modality hyperalgesia, increased pain and impaired physical function.Clin. J. Pain20182411521
    [Google Scholar]
  31. HochmanJ.R. FrenchM.R. BerminghamS.L. HawkerG.A. The nerve of osteoarthritis pain.Arthritis Care Res. (Hoboken)2010621019102310.1002/acr.20142
    [Google Scholar]
  32. TrouvinA-P. PerrotS. New concepts of pain.Best Pract. Res. Clin. Rheumatol.201933310141510.1016/j.berh.2019.04.007 31703792
    [Google Scholar]
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  • Article Type:
    Research Article
Keyword(s): bilateral knee OA; fibromyalgia; Neuropathy; osteoarthritis; rheumatology; VAS pain
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