Systematic review and meta-analysis of the prevalence of neuropathic-like pain and/or pain sensitization in people with knee and hip osteoarthritis

Zolio L 1 , Lim KY 2 , McKenzie JE 3 , Yan MK 4 , Estee M 5 , Hussain SM 6 Show all authors , Cicuttini F 7 , Wluka A 8

Affiliations 

  • 1 Alfred Health, Melbourne, VIC, Australia. Electronic address: drluigizolio@gmail.com
  • 2 School of Medicine, Monash University, Subang Jaya Selangor, Malaysia. Electronic address: kying.0131@gmail.com
  • 3 School of Public Health and Preventive Medicine, Monash University, Australia. Electronic address: joanne.mckenzie@monash.edu
  • 4 Alfred Health, Melbourne, VIC, Australia. Electronic address: mabelkyan@gmail.com
  • 5 Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: mest0004@student.monash.edu
  • 6 Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: monira.hussain@monash.edu
  • 7 Alfred Health, Melbourne, VIC, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: Flavia.Cicuttini@monash.edu
  • 8 Alfred Health, Melbourne, VIC, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia. Electronic address: anita.wluka@monash.edu
Osteoarthritis Cartilage, 2021 08;29(8):1096-1116.
PMID: 33971205 DOI: 10.1016/j.joca.2021.03.021

Abstract

OBJECTIVE: To determine the prevalence of neuropathic-like pain (NP) and pain sensitization (PS) defined by self-report questionnaires in knee and hip osteoarthritis, and whether prevalence is potentially explained by disease-severity or affected joint.

DESIGN: MEDLINE, EMBASE, CINAHL were systematically searched (1990-April 2020) for studies describing the prevalence of NP and PS in knee and hip osteoarthritis using self-report questionnaires. Random-effects meta-analysis was performed. Statistical heterogeneity between studies and sub-groups (affected joint and population source as a proxy for disease severity) was assessed (I2 statistic and the Chi-squared test).

RESULTS: From 2,706 non-duplicated references, 39 studies were included (2011-2020). Thirty-six studies reported on knee pain and six on hip pain. For knee osteoarthritis, the pooled prevalence of NP was: using PainDETECT, possible NP(score ≥13) 40% (95%CI 32-48%); probable NP(score >18) 20% (95%CI 15-24%); using Self-Report Leeds Assessment of Neuropathic Symptoms and Signs, 32% (95%CI 26-38%); using Douleur Neuropathique (DN4) 41% (95% CI 24-59%). The prevalence of PS using Central Sensitization Inventory (CSI) was 36% (95% CI 12-59%). For hip osteoarthritis, the pooled prevalence of NP was: using PainDETECT, possible NP 29% (95%CI 22-37%%); probable NP 9% (95%CI 6-13%); using DN4 22% (95%CI 12-31%) in one study. The prevalence of possible NP pain was higher at the knee (40%) than the hip (29%) (difference 11% (95% CI 0-22%), P = 0.05).

CONCLUSIONS: Using self-report questionnaire tools, NP was more prevalent in knee than hip osteoarthritis. The prevalence of NP in knee and hip osteoarthritis were similar for each joint regardless of study population source or tool used. Whether defining NP using self-report questionnaires enables more effective targeted therapy in osteoarthritis requires investigation.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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