Correlates of knee pain in older adults: Tasmanian older adult cohort study
Version of Record online: 31 MAR 2006
Copyright © 2006 by the American College of Rheumatology
Arthritis Care & Research
Volume 55, Issue 2, pages 264–271, 15 April 2006
How to Cite
Zhai, G., Blizzard, L., Srikanth, V., Ding, C., Cooley, H., Cicuttini, F. and Jones, G. (2006), Correlates of knee pain in older adults: Tasmanian older adult cohort study. Arthritis & Rheumatism, 55: 264–271. doi: 10.1002/art.21835
- Issue online: 31 MAR 2006
- Version of Record online: 31 MAR 2006
- Manuscript Accepted: 22 SEP 2005
- Manuscript Received: 20 MAY 2005
- National Health and Medical Research Council of Australia
- Tasmanian Community Fund
- Masonic Centenary Medical Research Foundation
- Royal Hobart Hospital Research Foundation
- Arthritis Foundation of Australia
- Knee pain;
- Chondral defects;
- Bone marrow lesions;
- Knee and hip radiographic OA
To describe the association between chondral defects, bone marrow lesions, knee and hip radiographic osteoarthritis (OA), and knee pain.
Knee pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index. T1- and T2-weighted fat saturation magnetic resonance imaging was performed on the right knee to assess chondral defects and subchondral bone marrow lesions. Radiography was performed on the right knee and hip and scored for radiographic OA. Body mass index (BMI) and knee extension strength were measured.
A total of 500 randomly selected men and women participated. The prevalence of knee pain was 48%. In multivariable analysis, prevalent knee pain was significantly associated with medial tibial chondral defects (odds ratio [OR] 2.32, 95% confidence interval [95% CI] 1.02–5.28 for grade 3 versus grade 2 or less; OR 4.93, 95% CI 1.07–22.7 for grade 4 versus grade 2 or less), bone marrow lesions (OR 1.44, 95% CI 1.04–2.00 per compartment), and hip joint space narrowing (OR 1.36, 95% CI 1.07–1.73 per unit), as well as greater BMI and lower knee extension strength. It was not significantly associated with radiographic knee OA. These variables were also associated with more severe knee pain. In addition, there was a dose response association between knee pain and number of sites having grade 3 or 4 chondral defects (OR 1.39, 95% CI 1.12–1.73 per site), with all subjects having knee pain if all compartments of the knee had these defects.
Knee pain in older adults is independently associated with both full and non–full-thickness medial tibial chondral defects, bone marrow lesions, greater BMI, and lower knee extension strength, but is not associated with radiographic knee OA. The association between radiographic hip OA and knee pain indicates that referred pain from the hip needs to be considered in unexplained knee pain.