Evidence map›Paper›PMID 40569498›Full record

ArticleClinical rheumatology2025

The relation between radiographic knee osteoarthritis severity and pain is stronger among more frail people.

Carson Halliwell, Sophie E Rayner, Jocelyn Waghorn, Brett Feltmate, Rebecca Moyer, Myles W O'Brien

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Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Carson HalliwellSchool of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada.ORCID http://orcid.org/0009-0003-7520-3515
Sophie E RaynerSchool of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
Jocelyn WaghornDivision of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
Brett FeltmateDivision of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
Rebecca MoyerSchool of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada.ORCID http://orcid.org/0000-0003-1719-4799
Myles W O'BrienCentre de Formation Médicale du Nouveau-Brunswick, Moncton, NB, Canada. Myles.OBrien@USherbrooke.ca.ORCID http://orcid.org/0000-0002-0665-5062

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION/

objectivesKnee osteoarthritis is a leading cause of disability in older adults; with treatment complicated by inconsistent associations between radiographic and symptomatic severity. Frailty describes the heterogeneity in aging and is quantified via the accumulation of health deficits. We test if frailty moderates the relation between radiographic and symptomatic knee osteoarthritis.

methodThis cohort study included participants (n = 3,271; 58% female, 45-79 years) from the Osteoarthritis Initiative were included. Radiographic severity was assessed using the Kellgren-Lawrence Grade (KLG). Frailty was quantified via a 31-item frailty index, categorizing participants as non-frail (≤ 0.10), very mild frailty (< 0.1-to- ≤ 0.2), mild frailty (< 0.2-to- ≤ 0.3), and moderate-to-severe frailty (> 0.3). Self-reported pain was assessed via the Knee Injury and Osteoarthritis Outcome Score (KOOS). Moderation models using generalized estimating equations adjusted for age, sex, and body mass index were performed to test the interaction between frailty and KLG on KOOS pain scores.

resultsRadiographic severity (β = -3.82, 95%CI: -4.16:-3.49; p < 0.001) and frailty (β = -4.76, 95%CI: -5.36:-4.17; p < 0.001) were negatively associated with KOOS pain scores. Frailty moderated this relation (interaction term: β = -1.18, 95%CI: -1.63:-0.73, p < 0.001), where higher frailty strengthened the association between radiographic severity and pain. Simple slopes analysis indicated stronger associations between KLG and KOOS pain scores in participants with mild to moderate-to-severe frailty compared to non-frail and very mild frailty (non-frail: β = -2.71, 95%CI: -3.41:-2.02, p < 0.001; moderate-to-severe frailty: β = -5.57, 95%CI: -7.23:-3.87, p < 0.001).

conclusionThese findings underscore the importance of incorporating frailty assessments into knee osteoarthritis management, as individuals with similar radiographic severity may experience substantially worse pain if they have higher frailty levels.

Indexed as

FrailtyKnee JointOsteoarthritis, KneePainAgedCohort StudiesFemaleFrail ElderlyHumansMaleMiddle AgedPain MeasurementRadiographySeverity of Illness IndexAge-related deficitsFrailty IndexKnee PainModifyPatient-reported outcomesRadiographic

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PMID40569498

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.