Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Impact of Painful Knee OA on Mortality Assessed

Osteoarthritis Cartilage; ePub 2018 Dec 21; Cleveland, et al

Individuals who had knee pain, alone or with knee radiographic osteoarthritis (rOA), had increased mortality, a recent study found. These effects were particularly strong among patients who were obese. Therefore, interventions to reduce knee pain, particularly those including weight management and prevention of comorbidities, could reduce mortality. Researchers analyzed data from 4,182 participants in a community-based prospective cohort study of men and women aged ≥45 years. Participants completed knee radiographs and questionnaires at baseline and at up to 3 follow-ups to determine rOA, knee pain, and covariate status. They found:

  • Median follow-up time was 14.6 years during which 1,822 deaths occurred.
  • Baseline rOA was 27.7%, 38.8% at first follow-up, 52.6% at second follow-up, and 61.9% at the third follow-up.
  • Knee rOA with pain and knee pain alone were both associated with a >15% increase in premature all-cause mortality.
  • In analyses stratified by sex, race, and age, associations between knee pain, with or without knee rOA, and all-cause death were found among women, Caucasians, those aged ≤65 years, and those with a body mass index (BMI) ≥30, with observed increased risks of death between 21% and 65%.


Cleveland RJ, Alvarez C, Schwartz TA, et al. The impact of painful knee osteoarthritis on mortality: A community-based cohort study with over 24 years of follow-up. [Published online ahead of print December 21, 2018]. Osteoarthritis Cartilage. doi:10.1016/j.joca.2018.12.008.

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