4,182 Patient Study Finds Knee Pain Increases Mortality

A new prospective cohort study of 4,182 men and women ≥45 years of age found that knee pain—with or without radiographic osteoarthritis (OA)—correlates with higher rates of death. This new study was conducted by a team of scientists from the University of North Carolina Thurston Arthritis Research Center at Chapel Hill in collaboration with Harvard’s Brigham and Women’s Hospital.

The study, “The impact of painful knee osteoarthritis on mortality: a community-based cohort study with over 24 years of follow-up,” was published in the April 19, 2019 edition of Osteoarthritis and Cartilage.

Co-author Leigh F. Callahan, Ph.D., the Mary Link Briggs Distinguished Professor of Medicine and associate director of the Thurston Arthritis Research Center, described the genesis of this potentially landmark study to OTW, “We know that osteoarthritis is the most common musculoskeletal condition in adults. It is also one of the leading causes of disability and is associated with increased frequency of diabetes and cardiovascular disease.”

“However, in our view, the impact of OA is often underestimated. As a result of the increased disability and morbidity noted in those with knee OA, we sought to develop a more thorough understanding of mortality outcomes associated with knee OA.”

For their study, the researchers were able to achieve a median patient follow-up of 14.6 years during which time 1,822 deaths were observed by the investigators in the study population. According to the researchers, the baseline knee radiographic evidence of osteoarthritis was 27.7%, then 38.8% at first follow-up, then 52.6% at second follow-up and, finally, 61.9% at the third follow-up.

According to the researchers, knee osteoarthritis with pain and knee pain alone (without radiographic evidence of osteoarthritis) were both associated with a greater than 15% increase in death from any cause.

Dr. Callahan, also director of the Osteoarthritis Action Alliance at UNC, explained the results to OTW, “Individuals with knee pain were more likely to die during follow-up than those without knee pain. This was true for both those who had radiographic knee OA findings and those who did not. Further, these patterns of association were seen only in women, Caucasians, individuals under the age of 65 and those who were obese.”

“Clinicians should pay close attention to their patients with knee pain to help them avoid severe disability and comorbidities, particularly obesity, to reduce chances of increased mortality. Patients with knee pain and knee OA are at increased risk of death due to their condition. However, helping them to avoid further disability and weight gain should reduce comorbidities and obesity in order to preserve quality of life.”