Examining sex differences in knee pain: the multicenter osteoarthritis study - PubMed (original) (raw)

Multicenter Study

Examining sex differences in knee pain: the multicenter osteoarthritis study

N Glass et al. Osteoarthritis Cartilage. 2014 Aug.

Abstract

Objective: To determine whether women experience greater knee pain severity than men at equivalent levels of radiographic knee osteoarthritis (OA).

Design and methods: A cross-sectional analysis of 2712 individuals (60% women) without knee replacement or a recent steroid injection. Sex differences in pain severity at each Kellgren-Lawrence (KL) grade were assessed by knee using visual analog scale (VAS) scale and Western Ontario and McMaster Universities Arthritis Index (WOMAC) with and without adjustment for age, analgesic use, Body mass index (BMI), clinic site, comorbid conditions, depression score, education, race, and widespread pain (WSP) using generalized estimating equations. Effect sizes (Cohen's d) were also calculated. Analyses were repeated in those with and without patellofemoral OA (PFOA).

Results: Women reported higher VAS pain at all KL grades in unadjusted analyses (d = 0.21-0.31, P < 0.0001-0.0038) and in analyses adjusted for all covariates except WSP (d = 0.16-0.22, P < 0.0001-0.0472). Pain severity differences further decreased with adjustment for WSP (d = 0.10-0.18) and were significant for KL grade ≤2 (P = 0.0015) and 2 (P = 0.0200). Presence compared with absence of WSP was associated with significantly greater knee pain at all KL grades (d = 0.32-0.52, P < 0.0001-0.0008). In knees with PFOA, VAS pain severity sex differences were greater at each KL grade (d = 0.45-0.62, P = 0.0006-0.0030) and remained significant for all KL grades in adjusted analyses (d = 0.31-0.57, P = 0.0013-0.0361). Results using WOMAC were similar.

Conclusions: Women reported greater knee pain than men regardless of KL grade, though effect sizes were generally small. These differences increased in the presence of PFOA. The strong contribution of WSP to sex differences in knee pain suggests that central sensitivity plays a role in these differences.

Keywords: Knee osteoarthritis; Knee pain; Sex differences.

Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

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Figures

Figure 1

Figure 1

Participant Inclusion Diagram

Figure 2

Figure 2

Frequency of Knees by KL Grade in Women and Men

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References

    1. Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman B, Aliabadi P, et al. Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study. Arthritis Rheum. 1997;40:728–733. - PubMed
    1. Oliveria SA, Felson DT, Reed JI, Cirillo PA, Walker AM. Incidence of symptomatic hand, hip and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum. 1995;38:1134–1141. - PubMed
    1. Ebrahimpour PB, Do HT, Bornstein LJ, Westrich GH. Relationship between demographic variables and preoperative pain and disability in 5945 total joint arthroplasties at a single institution. The Journal of arthroplasty. 2011;26:133–137. e1. - PubMed
    1. Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R, et al. Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med. 2000;342:1016–1022. - PubMed
    1. Elbaz A, Debbi EM, Segal G, Haim A, Halperin N, Agar G, et al. Sex and body mass index correlate with Western Ontario and McMaster Universities Osteoarthritis Index and quality of life scores in knee osteoarthritis. Archives of physical medicine and rehabilitation. 2011;92:1618–1623. - PubMed

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