Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

N Glass; N.A Segal; K.A Sluka; J.C Torner; M.C Nevitt; D.T Felson; L.A Bradley; T Neogi; C.E Lewis; L.A Frey-Law

doi:10.1016/j.joca.2014.06.030

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Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

Journal article

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Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

N Glass, N.A Segal, K.A Sluka, J.C Torner, M.C Nevitt, D.T Felson, L.A Bradley, T Neogi, C.E Lewis and L.A Frey-Law

Osteoarthritis and cartilage, Vol.22(8), pp.1100-1106

08/2014

DOI: 10.1016/j.joca.2014.06.030

PMCID: PMC4180745

PMID: 24999111

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Abstract

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

Knee pain

Sex differences

Knee osteoarthritis

Details

Title: Subtitle: Examining sex differences in knee pain: the Multicenter Osteoarthritis Study
Creators: N Glass - University of Iowa, Iowa City, IA, USA
N.A Segal - University of Iowa, Iowa City, IA, USA
K.A Sluka - University of Iowa, Iowa City, IA, USA
J.C Torner - University of Iowa, Iowa City, IA, USA
M.C Nevitt - University of California at San Francisco, San Francisco, CA, USA
D.T Felson - Boston University, Boston, MA, USA
L.A Bradley - University of Alabama at Birmingham, Birmingham, AL, USA
T Neogi - Boston University, Boston, MA, USA
C.E Lewis - University of Alabama at Birmingham, Birmingham, AL, USA
L.A Frey-Law - University of Iowa, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Osteoarthritis and cartilage, Vol.22(8), pp.1100-1106
DOI: 10.1016/j.joca.2014.06.030
PMID: 24999111
PMCID: PMC4180745
NLM abbreviation: Osteoarthritis Cartilage
ISSN: 1063-4584
eISSN: 1522-9653
Publisher: Elsevier Ltd
Language: English
Date published: 08/2014
Academic Unit: Epidemiology; Iowa Neuroscience Institute; Orthopedics and Rehabilitation; Surgery; Nursing; Physical Therapy and Rehabilitation Science; Injury Prevention Research Center; Neuroscience and Pharmacology; Neurosurgery
Record Identifier: 9983995052402771

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