rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2013-1249rsp-1150Research ArticleСтатьиArticlesБоль как один из факторов риска прогрессирования остеоартроза коленных суставовPain as one of the risk factors for progression of knee osteoarthrosisКашевароваН. Г.KashevarovaNatalia Gavriilovnanat-kash@yandex.ruЗайцеваЕ. М.ZaitsevaE M-СмирновА. В.SmirnovA V-АлексееваЛюдмила ИвановнаAlekseevaL I-201304112013514№4 (2013)387390Copyright © Кашеварова Н.Г., Зайцева Е.М., Смирнов А.В., Алексеева Л.И., 20132013Кашеварова Н.Г., Зайцева Е.М., Смирнов А.В., Алексеева Л.И.Kashevarova N.G., Zaitseva E.M., Smirnov A.V., Alekseeva L.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1150

Цель исследования — изучить влияние интенсивности боли на прогрессирование остеоартроза (ОА) коленных суставов. Материал и методы. 110 женщин с ОА коленных суставов обследованы с интервалом в 5 лет. Всем больным проводили анкетирование, оценку боли в коленных суставах по визуальной аналоговой шкале (ВАШ) и стандартную рентгенографию. Результаты. Через 5 лет наблюдения рентгенологическое прогрессирование наблюдалось у 40 пациентов (2-я группа), у 70 стадия осталась прежней (1-я группа). Больные в обеих группах были сопоставимы по возрасту (59,2+9,5 и 59,0+8,1 года) и длительности заболевания (11,1±10,6 и 13,7+9,9 года). При первом исследовании боль при ходьбе была более выраженной в 1-й группе, по сравнению со 2-й группой: 57,8+16,6 против 48,7+13,3 мм по ВАШ (р=0,002), а также у этих пациентов преобладала сильная боль в суставах: 22,5% против 11,4% соответственно. За 5-летний период отмечено увеличение интенсивности боли. В конце наблюдения больные из группы с прогрессированием ОА оценили боль в коленных суставах как сильную в 35% случаев, тогда как в группе без прогрессирования этот показатель составил всего 12,9% (р=0,012). Заключение. В группе с прогрессированием ОА интенсивность боли изначально была статистически выше, чем в группе без прогрессирования. За 5-летний период наблюдения в 1-й группе отмечено увеличение интенсивности боли в коленных суставах при ходьбе, которую можно рассматривать как один из предикторов прогрессирования гонартроза.

Objective: to study the impact of pain intensity on the progression of knee osteoarthrosis (OA). Subjects and methods. One hundred and ten patients with knee OA were examined at a 5-year interval. All the patients underwent a questionnaire survey and knee joint pain assessment using a visual analog scale (VAS) and standard radiography. Results. After 5-year follow-up, radiographic OA progression was seen in 40 patients (Group 2); its stage remained the same in 70 patients (Group 1). In both groups, the patients were matched for age (59.2+9.5 and 59.0+8.1 years) and disease duration (11.1+10.6 and 13.7+9.9 years). During the first examination, pain on walking was more severe in Group 1 than in Group 2: 57.8+16.6 and 48.7+13.3 mm by VAS (р=0.002), as well as severe joint pain was predominant in these patients: 22.5 and 11.4%, respectively. Over the 5-year period, there was an increase in pain intensity. At the end of the follow-up, the patients with progressive OA rated their knee joint pain as severe in 35% of cases whereas in this index the non-progression group was only 12.9 (p = 0.012). Conclusion. In the OA progression group, pain intensity was initially statistically higher than that in the non-progression group. During 5-year follow-up, Group 1 showed an increase in knee joint pain intensity on walking, which can be considered as one of the predictors of gonarthrosis progression.

остеоартроз коленных суставовинтенсивная больрентгенологическое прогрессированиеknee osteoarthrosisintensive painradiographic progressionReferences<div><p>Hart D.J., Spector T.D., Brown P. et al. Clinical signs of early osteoarthritis: reproducibility and relation to x ray changes in 541 women in the general population. Ann Rheum Dis 1991;50:467-70.</p><p>Felson D.T. The epidemiology of knee osteoarthritis: results from the Framingham Osteoarthritis Study. Semin Arthr Rheum 1990;20:42-50.</p><p>Claessens A.A., Schouten J.S.A.G., van den Ouweland F.A., Valkenburg H.A. Do clinical findings associate with radiographic osteoarthritis of the knee? Ann Rheum Dis 1990;49:771-4.</p><p>Bedson J., Croft P.R. The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature. BMC Musculoskeletal Disorders 2008;9:116.</p><p>Lanyon P., O'Reilly S., Jones A., Doherty M. Radiographic assessment of symptomatic knee osteoarthritis in the community: definitions and normal joint space. Ann Rheum Dis 1998;57:595-601.</p><p>McAlindon T.E., Snow S., Cooper C., Dieppe P.A. Radiographic patterns of osteoarthritis of the knee joint in the community: The importance of the patellofemoral joint. Ann Rheum Dis 1992;51:844-9.</p><p>Lachance L., Sowers M., Jamadar D. et al. The experience of pain and emergent osteoarthritis of the knee. Osteoarth Cartilage 2001;9:527-32.</p><p>Petersson I.F., Boegard T., Saxne T. et al. Radiographic osteoarthritis of the knee classified by the Ahlback and Kellgren and Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis 1997;56:493-6.</p><p>Ang D.C., Ibrahim S.A., Burant C.J., Kwoh C.K. Is there a difference in the perception of symptoms between African Americans and Whites with osteoarthritis? J Rheumatol 2003;30:1305-10.</p><p>Cicuttini F.M., Baker J., Hart D.J., Spector T.D. Association of pain with radiological changes in different compartments and views of the knee joint. Osteoarthr Cartilage 1996;4:143-7.</p><p>Davis M.A., Ettinger W.H., Neuhaus J.M. et al. Correlates of knee pain among US adults with and without radiographic knee osteoarthritis. J Rheumatol 1992;19:1943-9.</p><p>Odding E., Valkenburg H.A., Algra D. et al. Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam study. Ann Rheum Dis 1998;57:203-8.</p><p>Wolfe F., Lane N.E. The longterm outcome of osteoarthritis: rates and predictors ofjoint space narrowing in symptomatic patients with knee osteoarthritis. J Rheumatol 2002;29:139-46.</p><p>Dieppe P., Cushnaghan J., Young P., Kirwan J. Prediction of the progression of joint space narrowing in osteoarthritis of the knee by bone scintigraphy. Ann Rheum Dis 1993;52:557-63.</p><p>Cooper C., Snow S., McAlindon T.E. et al. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthr Rheum 2000;43:995-1000.</p><p>Amin S., Guermazi A., Lavalley M.P. et al. Complete anterior cruciate ligament tear and the risk for cartilage loss and progression of symptoms in men and women with knee osteoarthritis. Osteoarthr Cartilage 2008;16:897-902.</p><p>Altman R., Asch E., Bloch D. et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Arthr Rheum 1986;29:1039-49.</p><p>Conaghan P.G., DAgostino M.A., Le Bars M. et al. Clinical and ultrasonographic predictors ofjoint replacement for knee osteoarthritis: results from a large, 3-year, prospective EULAR study. Ann Rheum Dis 2010;69:644-7.</p><p>Rogers M.W., Wilder F.V. The association of BMI and knee pain among persons with radiographic knee osteoarthritis: A cross-sectional study. BMC Musculoskelet Disord 2008;9:163.</p><p>Neogi T., Nevitt M., Niu J. et al. Subchondral bone attrition may be a reflection of compartment-specific mechanical load: the MOST Study. Ann Rheum Dis 2010;69:841-4.</p><p>Sowers M.F., Hayes C., Jamadar D. et al. Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis. Osteoarthr Cartilage 2003;11:387-93.</p></div><br /><div><p>Hart D.J., Spector T.D., Brown P. et al. Clinical signs of early osteoarthritis: reproducibility and relation to x ray changes in 541 women in the general population. Ann Rheum Dis 1991;50:467-70.</p><p>Felson D.T. The epidemiology of knee osteoarthritis: results from the Framingham Osteoarthritis Study. Semin Arthr Rheum 1990;20:42-50.</p><p>Claessens A.A., Schouten J.S.A.G., van den Ouweland F.A., Valkenburg H.A. Do clinical findings associate with radiographic osteoarthritis of the knee? Ann Rheum Dis 1990;49:771-4.</p><p>Bedson J., Croft P.R. The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature. BMC Musculoskeletal Disorders 2008;9:116.</p><p>Lanyon P., O'Reilly S., Jones A., Doherty M. Radiographic assessment of symptomatic knee osteoarthritis in the community: definitions and normal joint space. Ann Rheum Dis 1998;57:595-601.</p><p>McAlindon T.E., Snow S., Cooper C., Dieppe P.A. Radiographic patterns of osteoarthritis of the knee joint in the community: The importance of the patellofemoral joint. Ann Rheum Dis 1992;51:844-9.</p><p>Lachance L., Sowers M., Jamadar D. et al. The experience of pain and emergent osteoarthritis of the knee. Osteoarth Cartilage 2001;9:527-32.</p><p>Petersson I.F., Boegard T., Saxne T. et al. Radiographic osteoarthritis of the knee classified by the Ahlback and Kellgren and Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis 1997;56:493-6.</p><p>Ang D.C., Ibrahim S.A., Burant C.J., Kwoh C.K. Is there a difference in the perception of symptoms between African Americans and Whites with osteoarthritis? J Rheumatol 2003;30:1305-10.</p><p>Cicuttini F.M., Baker J., Hart D.J., Spector T.D. Association of pain with radiological changes in different compartments and views of the knee joint. Osteoarthr Cartilage 1996;4:143-7.</p><p>Davis M.A., Ettinger W.H., Neuhaus J.M. et al. Correlates of knee pain among US adults with and without radiographic knee osteoarthritis. J Rheumatol 1992;19:1943-9.</p><p>Odding E., Valkenburg H.A., Algra D. et al. Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam study. Ann Rheum Dis 1998;57:203-8.</p><p>Wolfe F., Lane N.E. The longterm outcome of osteoarthritis: rates and predictors ofjoint space narrowing in symptomatic patients with knee osteoarthritis. J Rheumatol 2002;29:139-46.</p><p>Dieppe P., Cushnaghan J., Young P., Kirwan J. Prediction of the progression of joint space narrowing in osteoarthritis of the knee by bone scintigraphy. Ann Rheum Dis 1993;52:557-63.</p><p>Cooper C., Snow S., McAlindon T.E. et al. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthr Rheum 2000;43:995-1000.</p><p>Amin S., Guermazi A., Lavalley M.P. et al. Complete anterior cruciate ligament tear and the risk for cartilage loss and progression of symptoms in men and women with knee osteoarthritis. Osteoarthr Cartilage 2008;16:897-902.</p><p>Altman R., Asch E., Bloch D. et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Arthr Rheum 1986;29:1039-49.</p><p>Conaghan P.G., DAgostino M.A., Le Bars M. et al. Clinical and ultrasonographic predictors ofjoint replacement for knee osteoarthritis: results from a large, 3-year, prospective EULAR study. Ann Rheum Dis 2010;69:644-7.</p><p>Rogers M.W., Wilder F.V. The association of BMI and knee pain among persons with radiographic knee osteoarthritis: A cross-sectional study. BMC Musculoskelet Disord 2008;9:163.</p><p>Neogi T., Nevitt M., Niu J. et al. Subchondral bone attrition may be a reflection of compartment-specific mechanical load: the MOST Study. Ann Rheum Dis 2010;69:841-4.</p><p>Sowers M.F., Hayes C., Jamadar D. et al. Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis. Osteoarthr Cartilage 2003;11:387-93.</p></div><br />

The authors declare that there are no conflicts of interest present.