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The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis
Arthritis Care and Research , 08/11/09

Felson DT et al. – Study demonstrates that the proprioceptive acuity as assessed by the accuracy of reproduction of the angle of knee flexion had modest effects on the trajectory of pain and physical functional limitation in knee osteoarthritis (OA).

Methods

An evaluation of whether individuals with impaired proprioceptive acuity increase the risk of OA or its worsening
longitudinal study of people with or at high risk of knee OA
At baseline, acuity as the amount of a subject's error when attempting to reproduce a test knee flexion angle was quantified
Proprioception was tested 10 times in the right leg and a person's worst score was used as their proprioceptive acuity
At baseline and the 30-mo f/u the following scores were assessed:
- Presence of frequent pain
- Obtained Western Ontario and McMasters Universities OA Index (WOMAC) scores, and
- Acquired posteroanterior and lateral weight-bearing knee radiographs read for K/L grade and individual radiographic features
Factors examined:
- Relation of baseline proprioceptive acuity in quartiles with baseline knee pain WOMAC pain score
- Self-reported physical function, and radiographic OA, and
- Changes from baseline in pain, physical function, and radiographic OA adjusted for age, sex, BMI, and quadriceps strength

Results

At baseline, proprioceptive acuity was associated with the presence and severity of knee pain but not with the presence of radiographic OA
However, among the 2,243 subjects with baseline acuity assessments and 30-mo f/u, no strong associations between proprioceptive acuity and development of adverse OA outcomes
Acuity was not associated with the new onset of frequent knee pain
Those with the worst acuity at baseline had slightly greater worsening of WOMAC pain scores and physical function scores vs those with the best proprioceptive acuity, whose pain and physical function score deteriorated less
Radiographic worsening was not associated with proprioceptive acuity

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