A biopsychosocial approach to phenotyping people with knee osteoarthritis awaiting total knee arthroplasty: A secondary cohort analysis - 20/11/24
, Lotte Meert a, b, c , Rob J.E.M. Smeets b, c, d , Gavin van der Nest e , Jonas Verbrugghe a, h , Peter Verdonk f, Frank Th.G. Rahusen g , Mira Meeus a, c, ⁎ Highlights |
• | Latent profile analysis phenotyping of biopsychosocial items in knee osteoarthritis. |
• | Two phenotypes were found in people with end-stage knee osteoarthritis. |
• | Phenotype 1 (28%) had worse biopsychosocial factors, but less structural damage. |
• | Phenotype 2 (72%) had better biopsychosocial factors, but more structural damage. |
• | Phenotype 1 had worse pain intensity one year after total knee arthroplasty. |
Abstract |
Background |
Previous research showed chronic post-total knee arthroplasty (TKA) pain in 20% of people with knee osteoarthritis (KOA). Various preoperative biopsychosocial-related factors have been described, but phenotyping people with KOA awaiting TKA based on these factors is still lacking. This could be relevant to understanding differences in TKA surgery responses.
Objective |
To identify phenotypes in people with KOA awaiting TKA and differences in post-TKA pain based on preoperative biopsychosocial factors.
Methods |
People with KOA awaiting TKA in 4 hospitals in Belgium and the Netherlands were included. A cross-sectional latent profile analysis was conducted on structural, metabolic, functional, pain-related, psychological and social variables. Concurrent validity was tested using 3-step multinomial logistic regression. The difference in one-year post-TKA pain was examined with linear mixed model analysis.
Results |
Two hundred and seventeen participants were included in the latent profile analysis with a mean (SD) age of 65.5 (7.7) years, including 109 women. A model with 2 phenotypes differed in 14 out of 21 variables. Participants with phenotype 2 (28%) had a higher body mass index (BMI), higher chance of having less structural damage (KOA grade), lower mean quadriceps strength and physical function (Knee Society Scoring System functional and 30-second chair stand test), higher pain intensity, number of pain locations, and indices of central sensitisation (temporal summation, central sensitisation inventory score, and lower pressure pain thresholds), higher pain catastrophising, anxiety and depression, and higher post-TKA pain intensity compared to phenotype 1 (72%). Concurrent validity was confirmed in 3 out of 4 variables.
Conclusions |
Phenotype 2 (28%) with nociplastic pain characteristics in combination with worse psychological factors, BMI, functional and structural factors, and phenotype 1 (72%) not representing these characteristics were identified. Phenotype 2 had worse pain intensity scores after TKA compared to phenotype 1. Attention to the characteristics of phenotype 2 is warranted concerning post-TKA pain.
Database registration |
The protocol is registered at ClinicalTrials.gov (NCT05380648).
Le texte complet de cet article est disponible en PDF.Key words : Phenotype, Knee osteoarthritis, Total knee arthroplasty, Biopsychosocial, Central sensitisation
List of abbreviations : 30CST, BIC, BMI, CI, CPM, CSI, HbA1c, IMMPACT, IPQR, KOA, KOOS, KSSS, LPA, M2SENS, NRS, PPT, QST, SPSS, STROBE, TKA, TS, VLMR
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Vol 67 - N° 8
Article 101895- novembre 2024 Retour au numéro
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