Diz Osteoartritinde Nöropatik Ağrı Değerlendirmesi: Yaşam Kalitesi ve Fonksiyonel Durum ile İlişkisi

Abstract

Introduction: Pain is a predominant complaint in knee OA. It is usually classified as nociceptive pain. However, the weak relationship between radiographic findings and the patient complaints indicates a multifactorial nature of this pain. In OA, it has been shown that plasticity could take place within the intraarticular somatosensorial structures and symptoms of neuropathic pain (NP) may occur. The purpose of this study was to investigate the frequency of NP in patients with primary knee OA and to evaluate the relationship of such pain with functional status and quality of life. Materials and Methods: Eighty-seven patients over 40 years of age who were admitted to Hacettepe University Department of Physical Medicine and Rehabilitation Department with knee pain and who were diagnosed with primary knee OA according to the ACR criteria. DN4 and PainDETECT scales were used as NP screening questionnaires. Pain and functional status were assessed by VAS and WOMAC, and quality of life was assessed by SF-12. Results: Of 87 patients, 72 (82.75%) were female and 15 (17.25%) were male. Average age and BMI values were 64.04 ± 9.37 and 30.64 ± 5.18, respectively. According to DN4, %39.08 of patients had NP component. There was no significant difference between the groups with (n = 34) and without (n = 53) NP in terms of gender, age, BMI, VAS, radiological stage (all p > 0.05). Average WOMAC-pain, WOMAC-function, WOMAC-stiffness and WOMAC-total scores of the group with NP were significantly higher and average SF-12 mental score was significantly lower (p <0.05) than the the group without. According to PainDETECT, the NP component was not positive in %21.90 patients, uncertain in %19.50 and absent in %59.60 patients. Among the groups, while there was no significant difference in terms of gender, age, BMI, VAS, radiological stage and SF-12 scores (all p > 0.05); average WOMAC-pain, WOMAC-function and WOMAC-total scores were significantly different (p < 0.05). Conclusion: The frequency of NP component in symptomatic primary knee OA was %39.08 and %40.4 according to DN4 and PainDETECT, respectively. Patients with NP have higher knee pain severity and lower functional status - independent of the degenerative changes. NP should also be considered in the treatment of primary knee OA.