Cartilage lesions are not the main factor influencing pain and functional impairment in early knee osteoarthritis: a multivariate analysis on intra- and extra-articular factors affecting symptoms in over 200 knees
Aims: To investigate the correlation between symptoms, in terms of pain and functional scores, and the extent of cartilage damage as well as other intra- and extra-articular factors in patients suffering from early knee osteoarthritis (OA). Methods: The subjects were selected from the Osteoarthritis...
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The British Editorial Society of Bone & Joint Surgery
2025-07-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.67.BJO-2025-0010.R1 |
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| author | Luca Bianco Prevot Alessandro Bensa Pietro S Randelli Giuseppe Filardo |
| author_facet | Luca Bianco Prevot Alessandro Bensa Pietro S Randelli Giuseppe Filardo |
| author_sort | Luca Bianco Prevot |
| collection | DOAJ |
| description | Aims: To investigate the correlation between symptoms, in terms of pain and functional scores, and the extent of cartilage damage as well as other intra- and extra-articular factors in patients suffering from early knee osteoarthritis (OA). Methods: The subjects were selected from the Osteoarthritis Initiative database according to the following inclusion criteria: Kellgren-Lawrence (KL) grade 0-1-2, MRI at baseline, and availability of cartilage-denuded subchondral bone values. For each patient the following data were analyzed: demographic data, KL grade, percentage of subchondral bone denuded from cartilage, patellar quadriceps tendinitis, effusion, anserine bursa tenderness, meniscal extrusion, Hoffa body synovitis, bone marrow lesions (BML), visual analogue scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, and WOMAC pain subscale. Results: A total of 204 knees were included in the analysis. The multivariate analysis showed that VAS was influenced by patellar quadriceps tendinitis (p < 0.001/η2 = 0.113), anserine bursa tenderness (p = 0.009/η2 = 0.033), and percentage of cartilage-denuded subchondral bone (p = 0.032/η2 = 0.023). WOMAC was influenced by patellar quadriceps tendinitis (p < 0.001/η2 = 0.118), anserine bursa tenderness (p < 0.001/η2 = 0.060), medial meniscus extrusion (p < 0.001/η2 = 0.066), BML of the lateral compartment (p = 0.015/η2 = 0.029), patellofemoral BML (p = 0.096/η2 = 0.014), and percentage of cartilage-denuded subchondral bone (p = 0.083/η2 = 0.015). The WOMAC pain subscale was influenced by patellar quadriceps tendinitis (p < 0.001/η2 = 0.095), anserine bursa tenderness (p = 0.001/η2 = 0.055), medial meniscal extrusion (p < 0.001/η2 = 0.071), age (p = 0.032/η2 = 0.023), total BML (p = 0.001/η2 = 0.057), and percentage cartilage-denuded subchondral bone of the tibial plateau (p = 0.044/η2 = 0.020). Conclusion: The extent of cartilage damage is not the main factor influencing pain and functional impairment in early knee OA. Other intra- and extra-articular joint OA features, including extensor mechanism tendinitis, anserine bursa tenderness, meniscal extrusion, and BMLs have greater impact in driving patient symptoms. Cite this article: Bone Jt Open 2025;6(7):828–835. |
| format | Article |
| id | doaj-art-ccdb31700513485b837a6729bc46aaa6 |
| institution | Kabale University |
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| publishDate | 2025-07-01 |
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| spelling | doaj-art-ccdb31700513485b837a6729bc46aaa62025-08-20T03:58:49ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622025-07-016782883510.1302/2633-1462.67.BJO-2025-0010.R1Cartilage lesions are not the main factor influencing pain and functional impairment in early knee osteoarthritis: a multivariate analysis on intra- and extra-articular factors affecting symptoms in over 200 kneesLuca Bianco Prevot0Alessandro Bensa1Pietro S Randelli2Giuseppe Filardo3Residency Program in Orthopedics and Traumatology, University of Milan, Milan, ItalyService of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, SwitzerlandFirst Orthopedics Clinic, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, ItalyService of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, SwitzerlandAims: To investigate the correlation between symptoms, in terms of pain and functional scores, and the extent of cartilage damage as well as other intra- and extra-articular factors in patients suffering from early knee osteoarthritis (OA). Methods: The subjects were selected from the Osteoarthritis Initiative database according to the following inclusion criteria: Kellgren-Lawrence (KL) grade 0-1-2, MRI at baseline, and availability of cartilage-denuded subchondral bone values. For each patient the following data were analyzed: demographic data, KL grade, percentage of subchondral bone denuded from cartilage, patellar quadriceps tendinitis, effusion, anserine bursa tenderness, meniscal extrusion, Hoffa body synovitis, bone marrow lesions (BML), visual analogue scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, and WOMAC pain subscale. Results: A total of 204 knees were included in the analysis. The multivariate analysis showed that VAS was influenced by patellar quadriceps tendinitis (p < 0.001/η2 = 0.113), anserine bursa tenderness (p = 0.009/η2 = 0.033), and percentage of cartilage-denuded subchondral bone (p = 0.032/η2 = 0.023). WOMAC was influenced by patellar quadriceps tendinitis (p < 0.001/η2 = 0.118), anserine bursa tenderness (p < 0.001/η2 = 0.060), medial meniscus extrusion (p < 0.001/η2 = 0.066), BML of the lateral compartment (p = 0.015/η2 = 0.029), patellofemoral BML (p = 0.096/η2 = 0.014), and percentage of cartilage-denuded subchondral bone (p = 0.083/η2 = 0.015). The WOMAC pain subscale was influenced by patellar quadriceps tendinitis (p < 0.001/η2 = 0.095), anserine bursa tenderness (p = 0.001/η2 = 0.055), medial meniscal extrusion (p < 0.001/η2 = 0.071), age (p = 0.032/η2 = 0.023), total BML (p = 0.001/η2 = 0.057), and percentage cartilage-denuded subchondral bone of the tibial plateau (p = 0.044/η2 = 0.020). Conclusion: The extent of cartilage damage is not the main factor influencing pain and functional impairment in early knee OA. Other intra- and extra-articular joint OA features, including extensor mechanism tendinitis, anserine bursa tenderness, meniscal extrusion, and BMLs have greater impact in driving patient symptoms. Cite this article: Bone Jt Open 2025;6(7):828–835.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.67.BJO-2025-0010.R1early osteoarthritissymptomskneecartilage lesionsknee osteoarthritiscartilage lesionswestern ontario and mcmaster universities osteoarthritis indextendinitiscartilagebone marrow lesions (bml)subchondral bonekneesquadricepsmeniscal extrusion |
| spellingShingle | Luca Bianco Prevot Alessandro Bensa Pietro S Randelli Giuseppe Filardo Cartilage lesions are not the main factor influencing pain and functional impairment in early knee osteoarthritis: a multivariate analysis on intra- and extra-articular factors affecting symptoms in over 200 knees Bone & Joint Open early osteoarthritis symptoms knee cartilage lesions knee osteoarthritis cartilage lesions western ontario and mcmaster universities osteoarthritis index tendinitis cartilage bone marrow lesions (bml) subchondral bone knees quadriceps meniscal extrusion |
| title | Cartilage lesions are not the main factor influencing pain and functional impairment in early knee osteoarthritis: a multivariate analysis on intra- and extra-articular factors affecting symptoms in over 200 knees |
| title_full | Cartilage lesions are not the main factor influencing pain and functional impairment in early knee osteoarthritis: a multivariate analysis on intra- and extra-articular factors affecting symptoms in over 200 knees |
| title_fullStr | Cartilage lesions are not the main factor influencing pain and functional impairment in early knee osteoarthritis: a multivariate analysis on intra- and extra-articular factors affecting symptoms in over 200 knees |
| title_full_unstemmed | Cartilage lesions are not the main factor influencing pain and functional impairment in early knee osteoarthritis: a multivariate analysis on intra- and extra-articular factors affecting symptoms in over 200 knees |
| title_short | Cartilage lesions are not the main factor influencing pain and functional impairment in early knee osteoarthritis: a multivariate analysis on intra- and extra-articular factors affecting symptoms in over 200 knees |
| title_sort | cartilage lesions are not the main factor influencing pain and functional impairment in early knee osteoarthritis a multivariate analysis on intra and extra articular factors affecting symptoms in over 200 knees |
| topic | early osteoarthritis symptoms knee cartilage lesions knee osteoarthritis cartilage lesions western ontario and mcmaster universities osteoarthritis index tendinitis cartilage bone marrow lesions (bml) subchondral bone knees quadriceps meniscal extrusion |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.67.BJO-2025-0010.R1 |
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