Exploring the relationship between pain intensity and knee moments in participants with medial knee osteoarthritis: a cross-sectional study

Abstract Background High biomechanical loading is believed to be a risk factor to pain in people with knee osteoarthritis (OA), but controversial findings have been reported on the relationship between external knee adduction moment (KAM) and pain. A more comprehensive analysis considering other factor such as external knee flexion moment (KFM) could help better reveal this relationship. This study explored the relationship between external knee adduction moment and pain intensity in participants with knee osteoarthritis (OA) using an integrated path analysis model. Methods This was a cross-sectional study based on laboratory setting. Forty-seven participants with clinical and radiographic medial knee OA were analyzed for their external knee adduction moment (KAM) and knee flexion moment (KFM) during walking using a motion analysis system. Pain intensity was measured by visual analogue scale (VAS) and the pain subscale of the Knee Injury and Osteoarthritis Outcome Score. Varus/valgus alignment was captured and quantified using a bi-planar X-ray system. Using a path analysis model, the relationships between pain intensity, KAM, KFM, OA radiographic severity, knee varus angle and walking speed were examined. Results The proposed path model met the goodness-of-fit criteria. Based on this model, KAM had a negative effect on VAS pain indirectly through the mediation of KFM. The model indicated KAM and KFM were negatively related to one another; and KFM was positively related to VAS. The KAM index, defined as (KAM/ (KAM + KFM)), was negatively related to VAS. Conclusions Path analysis enabled the construction of a more integrated pathokinematic framework for people with knee OA. The KAM index which reflected the load sharing on the frontal and sagittal planes also revealed its relationship with pain. Re-distribution of mechanical loading from frontal to sagittal plane might be a strategy for pain avoidance associated with mechanical irritation.

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The Correlation of Supra Patella Effusion With Pain and Disability in Patients With Knee Osteoarthritis

Iranian Rehabilitation Journal ◽

10.32598/irj.18.2.931.1 ◽

2020 ◽

Vol 18 (2) ◽

pp. 155-162

Author(s):

Anahita Hasannejad ◽

◽

Hasan Namvar ◽

Kamran Ezzati ◽

Fatemeh Ghiasi ◽

...

Keyword(s):

Body Mass Index ◽

Knee Osteoarthritis ◽

Analogue Scale ◽

Sampling Method ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Knee Oa ◽

Relationship Of ◽

The Relationship

Objectives: The present research aimed to evaluate the relationship of supra patella effusion with pain and disability in patients with knee osteoarthritis by Ultrasonography (US). Methods: In a cross-sectional study, 60 patients with knee OA (Mean±SD score of body mass index: 29.81±5.64 kg/m2 and age: 50.48±7.57 years) were selected by nonprobability sampling method. Supra patella effusion was evaluated using an US. All study subjects completed the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain and disability outcomes, respectively. To evaluate the relationship between effusion, disability, and pain, the Pearson’s correlation coefficient was employed. Results: There was a poor but significant relationship between the area of effusion (r=0.27, P=0.03), the thickness of effusion (r=0.32, P=0.01), with pain. No correlation was found between the trace of effusion (r=-0.08, P=0.5) and pain. The area of effusion (r=0.1, P=0.17), the thickness of effusion (r=0.08, P=0.51), and the trace of effusion (r=0.0, P=0.9) were not correlated with disability. Discussion: The effusion of supra patella was slightly correlated with pain. In contrast, the effusion of supra patella demonstrated no correlation with disability.

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The Influence of Radiographic Severity on the Relationship between Muscle Strength and Joint Loading in Obese Knee Osteoarthritis Patients

Arthritis ◽

10.1155/2011/571519 ◽

2011 ◽

Vol 2011 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Jens Aaboe ◽

Henning Bliddal ◽

Tine Alkjaer ◽

Mikael Boesen ◽

Marius Henriksen

Keyword(s):

Muscle Strength ◽

Knee Osteoarthritis ◽

Knee Adduction Moment ◽

Joint Loading ◽

Cross Sectional ◽

Radiographic Severity ◽

Peak Knee ◽

The Relationship ◽

Knee Joint Loading ◽

External Knee Adduction Moment

Objective. To investigate the relationship between knee muscle strength and the external knee adduction moment during walking in obese knee osteoarthritis patients and whether disease severity influences this relationship. Methods. This cross-sectional study included 136 elderly obese (BMI>30) adults with predominant medial knee osteoarthritis. Muscle strength, standing radiographic severity as measured by the Kellgren and Lawrence scale, and the peak external knee adduction moment were measured at self-selected walking speed. Results. According to radiographic severity, patients were classified as “less severe” (KL 1-2, N=73) or “severe” (KL 3-4, N=63). A significant positive association was demonstrated between the peak knee adduction moment and hamstring muscle strength in the whole cohort (P=.047). However, disease severity did not influence the relationship between muscle strength and dynamic medial knee joint loading. Severe patients had higher peak knee adduction moment and more varus malalignment (P<.001). Conclusion. Higher hamstring muscle strength relates to higher estimates of dynamic knee joint loading in the medial compartment. No such relationship existed for quadriceps muscle strength. Although cross sectional, the results suggest that hamstrings function should receive increased attention in future studies and treatments that aim at halting disease progression.

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The Relationship Between Quadriceps Muscle Atrophy and Proprioception Function in Knee Osteoarthritis Patients

Surabaya Physical Medicine and Rehabilitation Journal ◽

10.20473/spmrj.v1i2.16177 ◽

2019 ◽

Vol 1 (2) ◽

pp. 59

Author(s):

Ayu Susanti ◽

Rr. Indrayuni Lukitra Wardhani ◽

I Putu Alit Pawana

Keyword(s):

Knee Osteoarthritis ◽

Pain Intensity ◽

Muscle Atrophy ◽

Quadriceps Muscle ◽

Joint Position Sense ◽

Osteoarthritis Of The Knee ◽

Cross Sectional ◽

Knee Oa ◽

Proprioceptive Function ◽

The Relationship

Background: Osteoarthritis of the knee (OA) patients can experience impaired proprioceptive function which causes instability, balance disorder and limited activity. Further analysis is needed to detect changes that occur. There are two methods to evaluate the speed and angle of a particular motion as an analysis of the function of proprioception, Time to Detect Passive Movements (TTDPM) and Joint Position Sense (JPS).Aim: To analyze the relationship between quadriceps muscle atrophy with proprioception in knee osteoarthritis patients.Methods: The design of this research is cross sectional analysis done in Dr. Soetomo General Hospital Surabaya, Indonesia. There were 25 knee OA patients (2 men and 23 women) with each subject had proprioception (JPS and TTDPM) function measured using isokinetics dynamometer on both sides of the knee.Results: This study shows the atrophic side had greater pain intensity and greater disturbance of proprioception. In addition, there were significant differences in JPS measurements at angle of 30⁰, and 60⁰ and TTDPM (p <0.05). No difference obtained at 45⁰ measurements angle.Conclusion: In this study, there was no association between quadriceps atrophy and function of proprioception in knee osteoarthritis patients. This was due to a number of confounding factors that cannot be controlled such as duration, difference in pain intensity, OA severity, physical activity before measurement, and fatigue which can affect proprioception function and bring misinterpretation on measurements.

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Association between meniscal tears and the peak external knee adduction moment and foot rotation during level walking in postmenopausal women without knee osteoarthritis: a cross-sectional study

Arthritis Research & Therapy ◽

10.1186/ar2428 ◽

2008 ◽

Vol 10 (3) ◽

pp. R58 ◽

Cited By ~ 15

Author(s):

Miranda L Davies-Tuck ◽

Anita E Wluka ◽

Andrew J Teichtahl ◽

Johanne Martel-Pelletier ◽

Jean-Pierre Pelletier ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Postmenopausal Women ◽

Cross Sectional Study ◽

Knee Adduction Moment ◽

Sectional Study ◽

Meniscal Tears ◽

Cross Sectional ◽

Level Walking ◽

External Knee Adduction Moment

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The Relationship Between Quadriceps Muscle Atrophy and Proprioception Function in Knee Osteoarthritis Patients

Surabaya Physical Medicine and Rehabilitation Journal ◽

10.20473/spmrj.v1i2.2019.59-64 ◽

2019 ◽

Vol 1 (2) ◽

pp. 59

Author(s):

Ayu Susanti ◽

Rr. Indrayuni Lukitra Wardhani ◽

I Putu Alit Pawana

Keyword(s):

Knee Osteoarthritis ◽

Pain Intensity ◽

Muscle Atrophy ◽

Quadriceps Muscle ◽

Joint Position Sense ◽

Osteoarthritis Of The Knee ◽

Cross Sectional ◽

Knee Oa ◽

Proprioceptive Function ◽

The Relationship

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Diet quality is associated with pain intensity and quality of life in a sample of patients with knee osteoarthritis: a cross-sectional study

Journal of Research in Clinical Medicine ◽

10.34172/jrcm.2020.006 ◽

2020 ◽

Vol 8 (1) ◽

pp. 6-6 ◽

Cited By ~ 1

Author(s):

Vahideh Toopchizadeh ◽

Dawood Aghamohammadi ◽

Neda Dolatkhah ◽

Saeede Asef ◽

Mohammad Rahbar ◽

...

Keyword(s):

Quality Of Life ◽

Fatty Acids ◽

Knee Osteoarthritis ◽

Pain Intensity ◽

Diet Quality ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Knee Oa

Introduction: Knee osteoarthritis (KOA) is the most common degenerative joint disease resulting in bone pain and disability. The aim of current study is to determine diet quality by healthy eating index (HEI)-2015 in association with pain and functional status among a sample of participants with primary knee OA. Methods: In this cross-sectional study, 220 patients with knee OA were recruited via convenience sampling in the outpatient clinics of Tabriz University of Medical Sciences between April and September 2018. The HEI-2015 score was calculated from dietary data collected using a Food Frequency Questionnaire (FFQ). Visual analogue scale, Western Ontario and McMaster Universities Osteoarthritis Index and the SF36 quality of life (QoL) questionnaire were applied to measure the pain intensity, functional status and QoL in the participants, respectively. Participants were categorized based on the quintile cutoff points of HEI score including 42-62, 63-69, 70-75, 76-78 and 79-100. Results: The mean score of HEI was 70.62±10.18 (range: 42–89). Participants with greater HEI- 2015 scores had higher total energy intake (P=0.008) and greater dietary intake of carbohydrates (P=0.01), protein (P=0.009), monounsaturated fatty acids (P=0.01), polyunsaturated fatty acids (P=0.007) and fiber (P=0.009) and lower intake of saturated fatty acids (P=0.005). Participants in higher quintiles of HEI had significantly lower pain intensity (P=0.001) and higher scores of physical function (P=0.001), pain (P=0.001) and role limitation due to physical problems (P=0.005) subscales of SF-36 QoL questionnaire in comparison with participants in lower quintiles of HEI-2015. Conclusion: The HEI-2015 score is associated with pain intensity and two domain of QoL in patients with knee OA.

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THE EFFECT OF A TRIPOD CANE ON THE FUNCTIONAL MOBILITY OF PATIENTS WITH KNEE OSTEOARTHRITIS

Berkala Ilmiah Kedokteran Duta Wacana ◽

10.21460/bikdw.v5i1.164 ◽

2020 ◽

Vol 5 (1) ◽

pp. 29

Author(s):

Nelson Sudiyono

Keyword(s):

Knee Osteoarthritis ◽

Cross Sectional Study ◽

Functional Mobility ◽

Cross Sectional ◽

Knee Oa ◽

Walking Aids ◽

Symptomatic Knee Osteoarthritis ◽

Symptomatic Knee ◽

Contralateral Hand ◽

Painful Knee

Background: Canes have been recommended as walking aids for knee osteoarthritis to reduce the loading on the affected knee. Patients are usually recommended to hold the cane in the contralateral hand to the affected knee. Nevertheless, some patients prefer to hold the cane ipsilateral to the affected knee. However, the effect of using ipsilateral or contralateral tripod cane on functional mobility in patients with knee osteoarthritis is still unknown Objective: To compare the immediate effect of ipsilateral and contralateral tripod cane usage on functional mobility in patients with symptomatic knee osteoarthritis Method: This cross-sectional study involved 30 overweight or obese patients with symptomatic unilateral or bilateral knee osteoarthritis (Kellgren Lawrence grade 2 and 3) who never use a cane. Functional mobility was evaluated with Time Up and Go test in three conditions; without walking aid, with tripod cane contralateral and ipsilateral to the more painful knee. Results: The TUG time of aid-free walking is 4.75 (p < 0.001, 95% CI 3.79 - 5.71) seconds faster than ipsilateral cane use and 6.69 (p < 0.001, 95%CI 5.35 - 8.03) seconds faster than contralateral cane use. The TUG time of ipsilateral cane use is 1,94 (95% CI, 1.13 - 2.79) seconds faster than contralateral. Conclusion: Patients with symptomatic knee OA who use tripod cane ipsilateral to the more painful knee have higher functional mobility than the contralateral.

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Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis

Physical Therapy ◽

10.2522/ptj.20140441 ◽

2016 ◽

Vol 96 (2) ◽

pp. 167-175 ◽

Cited By ~ 17

Author(s):

Naoto Fukutani ◽

Hirotaka Iijima ◽

Takahiko Fukumoto ◽

Daisuke Uritani ◽

Eishi Kaneda ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Activities Of Daily Living ◽

Daily Living ◽

Predictor Variable ◽

Cross Sectional Study ◽

Sensitivity Analyses ◽

Varus Alignment ◽

Cross Sectional ◽

Medial Knee ◽

Knee Oa

Background Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective The aim of this study was to investigate the association between varus thrust and 2 subcategories—“pain and stiffness” and “activities of daily living (ADL)”—of the Japanese Knee Osteoarthritis Measure (JKOM). Design This was a cross-sectional study. Methods In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis. Limitations Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study. Conclusions Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.

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Synovitis is associated with constant pain in knee osteoarthritis: a cross-sectional study of OMERACT knee ultrasound scores

The Journal of Rheumatology ◽

10.3899/jrheum.210285 ◽

2021 ◽

pp. jrheum.210285

Author(s):

Holly T. Philpott ◽

Trevor B. Birmingham ◽

Ryan Pinto ◽

Codie A. Primeau ◽

Dominique Arsenault ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Multinomial Logistic Regression ◽

Cross Sectional Study ◽

Cross Sectional ◽

Logistic Regression Models ◽

Knee Oa ◽

Pain Scores ◽

Constant Pain ◽

Secondary Analyses ◽

Pain Experiences

Objective To examine the association between ultrasound (US)-detected knee inflammation and intermittent and constant pain experiences in patients with knee osteoarthritis (OA). Methods Participants with radiographically early- (KL ≤ 2) and late-stage (KL ≥ 3) disease and frequent symptoms underwent musculoskeletal US measures of inflammation using the OMERACT knee US scoring system. Pain experiences were captured using the Intermittent and Constant OA Pain (ICOAP) tool. We assessed the association between US-synovitis and ICOAP pain experiences using a series of linear, logistic, or multinomial logistic regression models (as appropriate for each variable), while adjusting for age, sex, body mass index (BMI), and radiographic stage. Secondary analyses were performed similarly by radiographic stage. Results Pain and synovitis measures from 248 patients (453 knees) were included. Worse synovitis was associated with higher ICOAP constant pain scores (β 8.05 [95%CI 0.67, 15.43]), but not intermittent pain scores. Moderate-to-severe synovitis was associated with a 4.73-fold increased relative risk [95%CI 1.06, 8.80] of a constant pain pattern. In secondary analyses, moderate-to-severe synovitis in early radiographic OA was associated with 2.70-higher odds [95%CI 1.04, 7.02] of any constant pain, 3.28-higher odds [95%CI 1.43, 7.52] of any intermittent pain, and with higher intermittent (β 10.47 [95%CI 1.03, 19.91]) and constant (β 12.62 [95%CI 3.02, 22.23]) pain scores. No associations identified for synovitis in those with late radiographic OA. Conclusion In patients with knee OA, moderate-to-severe synovitis is most strongly associated with constant pain. Inflammation may play context-specific roles across pain experiences, especially in earlier radiographic stages of knee OA.

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Alteration of Screw-home Movement in Patients With Knee Osteoarthritis: A Cross-sectional Study

10.21203/rs.3.rs-35701/v1 ◽

2020 ◽

Author(s):

Jeongwoo Jeon ◽

Dongyeop Lee ◽

Jaeho Yu ◽

Jinseop Kim ◽

Sang Hoon Lhee ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Knee Extension ◽

Cross Sectional Study ◽

Measurement Unit ◽

Tibial Rotation ◽

Sectional Study ◽

Control Groups ◽

Cross Sectional ◽

Knee Oa ◽

And Control

Abstract Background: Tibial rotation accompanying sagittal movement contains the phenomenon of screw-home movement of the knee, which plays an important role in knee stability during extension. This study aimed to investigate the alteration of screw-home movement in patients with knee osteoarthritis (OA).Methods: Participants (n =67) in this cross-sectional study were outpatients in the department of orthopedics of a general hospital and included patients with knee OA (n=31) and asymptomatic control subjects (n=36).Knee kinematic data were measured using an inertial measurement unit. The total tibial rotation was obtainedduring knee sagittal movement. The acquired angle of tibial rotation was divided into four periodseach extension and flexion. The total tibial rotation and the variation of each period were compared between the OA and control groups.Results: Significant differences arose between the OA and control groups in the total tibial rotation during knee extension and flexion(P< 0.001).The variation of tibial rotation was also significantly different between groups for all periods (P< 0.001; knee extensionat 70° to 45°,P = 0.014).Conclusions: We found a reduction in the total tibial rotation and loss of the screw-home movement in the unloaded OA knee. To normalize the screw-home movement, it is necessary to promote proper articular movement of the knee joint and suppress the hyperexcitability of the medial muscles.

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