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Cartilage loss exerts small effect on knee pain

25 May 2020

Loss of cartilage thickness affects knee pain by a small degree, and this association is partly mediated by worsening synovitis, according to a study.

The study used data from the Osteoarthritis Initiative and included 600 adults (mean age, 62 years; 59 percent female; mean body mass index, 31 kg/m2) with or at risk of symptomatic knee osteoarthritis (OA) who were followed for 36 months. All participants underwent knee magnetic resonance imaging (MRI) at baseline, 12 months and 24 months for quantitative and semiquantitative measures of OA structural features.

About half of the population (51 percent) had mid-range OA by Kellgren and Lawrence Grade. The mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score at baseline averaged 2.4, increasing slightly by 0.62 and 0.93 by months 24 and 36, respectively.

Over 24 months, cartilage thinned by 0.10 mm in the medial tibiofemoral compartment, synovitis score increased (worsened) by 0.23, and bone marrow lesion (BML) size summary score decreased by −0.45.

Cartilage thickness loss was significantly associated with a small degree of worsening in knee pain, such that a loss of 0.1 mm over 2 years translated to an increase of 0.32 in WOMAC pain (scale 0–20). This association was mediated by synovitis change but not by BML change.

The finding that cartilage loss has such a tiny effect on pain indicate that demonstrating that chondroprotective treatment reduces knee pain will be extremely challenging and is perhaps unachievable, the researchers said.

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Most Read Articles
3 days ago
Routinely used for treating cardiovascular diseases, statins have been shown to benefit other conditions, and new evidence suggests that using the drug at high intensity reduces the risk of hip or knee replacement, an effect that may be specific to rheumatoid arthritis.
Jairia Dela Cruz, 3 days ago
Following vegan and vegetarian diets, which offer plenty of what is good for health, has been reported to have a downside: an increased risk of depression and anxiety, especially for younger adults.
Pearl Toh, 29 Jun 2020
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
Roshini Claire Anthony, Yesterday

Upadacitinib may be a suitable treatment for patients with active psoriatic arthritis (PsA) who have insufficient response to non-biologic disease-modifying anti-rheumatic drugs (non-bDMARDs), according to results of the phase III SELECT-PsA-1* trial presented at EULAR 2020.