Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Dec;22(12):2041-50.
doi: 10.1016/j.joca.2014.09.026. Epub 2014 Oct 8.

Pain trajectory groups in persons with, or at high risk of, knee osteoarthritis: findings from the Knee Clinical Assessment Study and the Osteoarthritis Initiative

E Nicholls  1 , E Thomas  2 , D A van der Windt  3 , P R Croft  4 , G Peat  5
Affiliations

Pain trajectory groups in persons with, or at high risk of, knee osteoarthritis: findings from the Knee Clinical Assessment Study and the Osteoarthritis Initiative

E Nicholls et al. Osteoarthritis Cartilage. 2014 Dec.

Abstract

Objective: The authors aimed to characterize distinct trajectories of knee pain in adults who had, or were at high risk of, knee osteoarthritis using data from two population-based cohorts.

Method: Latent class growth analysis was applied to measures of knee pain severity on activity obtained at 18-month intervals for up to 6 years between 2002 and 2009 from symptomatic participants aged over 50 years in the Knee Clinical Assessment Study (CAS-K) in the United Kingdom. The optimum latent class growth model from CAS-K was then tested for reproducibility in a matched sample of participants from the Osteoarthritis Initiative (OAI) in the United States.

Results: A 5-class linear model produced interpretable trajectories in CAS-K with reasonable goodness of fit and which were labelled "Mild, non-progressive" (N = 201, 35%), "Progressive" (N = 162, 28%), "Moderate" (N = 124, 22%) "Improving" (N = 68, 12%), and "Severe, non-improving" (N = 15, 3%). We were able to reproduce "Mild, non-progressive", "Moderate", and "Severe, non-improving" classes in the matched sample of participants from the OAI, however, absence of a "Progressive" class and instability of the "Improving" classes in the OAI was observed.

Conclusions: Our findings strengthen the grounds for moving beyond a simple stereotype of osteoarthritis as "slowly progressive". Mild, non-progressive or improving symptom trajectories, although difficult to reproduce, can nevertheless represent a genuinely favourable prognosis for a sizeable minority.

Keywords: Knee; Latent class growth analysis; Longitudinal; Osteoarthritis; Pain; Trajectories.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
WOMAC Pain Scores by Trajectory Group Membership for (A) CAS-K and (B) Matched OAI Sample (N = 570). Abbreviations: PYRC = Per-year rate of change in WOMAC points; 95% confidence interval in brackets.
See this image and copyright information in PMC

References

    1. Felson D.T., Lawrence R.C., Dieppe P.A., Hirsch R., Helmick C.G., Jordan J.M. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med. 2000;133:635–646. 200010170-00016. - PubMed
    1. Emrani P.S., Katz J.N., Kessler C.L., Reichmann W.M., Wright E.A., McAlindon T.E. Joint space narrowing and Kellgren–Lawrence progression in knee osteoarthritis: an analytic literature synthesis. Osteoarthritis Cartilage. 2008;16(8):873–882. - PMC - PubMed
    1. van Dijk G.M., Dekker J., Veenhof C., van den Ende C.H.M., CARPA Study Group Course of functional status and pain in osteoarthritis of the hip or knee: a systematic review of the literature. Arthritis Rheum. 2006;55(5):779–785. - PubMed
    1. Botha-Scheepers S., Kloppenburg M., Kroon H.M., Hellio Le Graverand M.P., Breedveld F.C., Ravaud P. Fixed-flexion knee radiography: the sensitivity to detect knee joint space narrowing in osteoarthritis. Osteoarthritis Cartilage. 2007;15(3):350–353. - PubMed
    1. Leyland K.M., Hart D.J., Javaid M.K., Judge A., Kiran A., Soni A. The natural history of radiographic knee osteoarthritis: a fourteen-year population-based cohort study. Arthritis Rheum. 2012;64(7):2243–2251. - PubMed

Publication types

LinkOut - more resources