• Pain Med · Jul 2021

    Association Between Clinical Symptoms and Radiographic Features in Late-Stage Knee Osteoarthritis Using a New Radiographic Parameter.

    • Tengjiao Zhu, Xing Xin, Bin Yang, Chen Liu, Bolong Kou, Zhongqiang Chen, and Ke Zhang.
    • Peking University Third Hospital, Beijing, China.
    • Pain Med. 2021 Jul 25; 22 (7): 1539-1547.

    ObjectiveIn this study, we proposed a new radiographic parameter, the plateau attrition index (PAI), and the PAI grades (PAIs) to explore the relationship between subchondral attrition of the tibial plateau and symptoms of knee osteoarthritis (OA) in patients with late-stage knee osteoarthritis.MethodOne hundred nineteen patients with late-stage knee osteoarthritis were enrolled. The Kellgren and Lawrence (K/L) grades and hip-knee-ankle (HKA) angle were used to characterize the radiographic features of knee OA. The bone attrition of the tibial plateau was determined by the PAI and PAIs. The symptoms of knee OA were assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which is composed of the WOMAC pain (WOMP), WOMAC stiffness (WOMS), and WOMAC function (WOMF) subscores. WOMAC pain scores were divided into non-weight-bearing pain (NWBP) and weight-bearing pain (WBP) subcategories. The Pearson correlation coefficient was used to determine the relationship between the PAI, HKA angle, and WOMAC scores. The Spearman rank correlation coefficient was used to evaluate the correlation between the WOMAC score and the PAIs and K/L grades.ResultsThe distribution of the WOMAC scores according to the PAIs was significant (P < .01). A positive correlation was identified between the PAI and the WOMAC, WOMP, WOMF and WBP scores (r = 0.29, 0.34, 0.26 and 0.34, P < .01, respectively). In addition, the PAIs was also significantly correlated with the WOMAC, WOMP, WOMF, and WBP scores (r = 0.37, 0.38, 0.35 and 0.44, P < .01, respectively).ConclusionsThe attrition of tibial subchondral bone determined by the new parameter, the plateau attrition index, was correlated with symptoms, especially weight-bearing pain in late-stage knee OA.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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