A new longitudinal study has found that race makes a difference when it comes to pain and disability among knee osteoarthritis (OA) patients. The research, “Natural History of Pain and Disability among African-Americans and Whites With or At Risk For Knee Osteoarthritis: A Longitudinal Study,” appears in the February 2, 2018 edition of Osteoarthritis and Cartilage.
Knee OA: Pain, Disability Greater in African Americans
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#osteoarthritisSecondary#knee#disability
Ernest R. Vina, M.D., M.S., assistant professor of medicine at the University of Arizona College of Medicine and co-author on the study, told OTW, “While previous studies had detected race differences in pain and disability among those with knee osteoarthritis (OA), no other study has ever tracked these race differences in knee-OA related symptoms with multiple observations over a long period of time.”
“The longitudinal study design makes this study in race differences among knee OA patients unique. We also estimated the average pain and disability of patients’ pain and disability, adjusted for relevant sociodemographic and clinical factors.”
“We found that self-reported pain and disability due to OA were persistently greater among African Americans (AA) than Whites (WH) throughout nine years of follow-up. African-Americans who are socioeconomically and clinically disadvantaged (e.g., those with low income, not married, obese) were the most affected. We also observed greater variability in reported symptoms among African Americans with OA than Whites with OA over time.”
“There should be better and more communication between patients and healthcare providers regarding patient reporting of knee OA related symptoms. There are various ways providers may assist patients on how to alleviate their symptoms from OA.”
“Providers who treat OA should be cognizant of race differences in patient-reported OA-related symptoms. They should also be aware that AAs, in comparison to WHs, may be more likely to have fluctuations of their symptoms. These should be taken into account when evaluating patients with the disease.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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