Dispositional traits help explain individual differences in relationships between a radiographic knee osteoarthritis measure, pain, and physical function

Angela M Mickle; Roland Staud; Cynthia S Garvan; Daniel A Kusko; Nicola Sambuco; Brittany R Addison; Kevin R Vincent; David T Redden; Burel R Goodin; Roger B Fillingim; Kimberly T Sibille

doi:10.1177/1759720X241235805

Dispositional traits help explain individual differences in relationships between a radiographic knee osteoarthritis measure, pain, and physical function

Ther Adv Musculoskelet Dis. 2024 Mar 21:16:1759720X241235805. doi: 10.1177/1759720X241235805. eCollection 2024.

Authors

Angela M Mickle^{1

2}, Roland Staud³, Cynthia S Garvan⁴, Daniel A Kusko⁵, Nicola Sambuco⁶, Brittany R Addison⁷, Kevin R Vincent⁷, David T Redden⁸, Burel R Goodin^{5

9}, Roger B Fillingim^{2

10}, Kimberly T Sibille^{7

4

10}

Affiliations

¹ Department of Physical Medicine & Rehabilitation, University of Florida, Campus Box 100242, 2004 Mowry Road, Gainesville, FL 32610, USA.
² Department of Community Dentistry, University of Florida, Gainesville, FL, USA.
³ Department of Medicine, University of Florida, Gainesville, FL, USA.
⁴ Department of Anesthesiology, University of Florida, Gainesville, FL, USA.
⁵ Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
⁶ Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
⁷ Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, USA.
⁸ Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
⁹ Department of Anesthesiology, Washington University, St. Louis, MO, USA.
¹⁰ Pain Research Center of Excellence, University of Florida, Gainesville, FL, USA.

Abstract

Background: The concordance between radiograph-derived Kellgren-Lawrence (KL) scores for knee osteoarthritis (KOA) and experimental and clinical pain and KOA-related physical function is conflicting.

Objectives: We investigate whether the inclusion of dispositional traits reduces variability between KOA radiographic findings, experimental pain, clinical pain, and function in individuals with knee pain.

Design: This study is a cross-sectional, secondary analysis of data collected from the UPLOAD-II study.

Methods: Adults aged 45-85 years with and without knee pain were enrolled. Data collected included sociodemographics, knee radiographs, experimental pain, clinical pain and function, and trait affect. Vulnerable and protective dispositional traits were classified from combined positive and negative trait affect measures. KL scores were determined from the knee radiographs. Unadjusted and adjusted (age, sex, comorbidities, and body mass index) regression analyses were completed with SAS version 9.4 (Cary, NC, USA).

Results: The study included 218 individuals with a mean age of 58 years, 63.6% women, and 48.2% non-Hispanic black adults. Dispositional traits were associated with the experimental pain measures. No association between radiographic KOA and experimental pain was observed. In a combined and adjusted analysis, dispositional traits were predictive of knee punctate pain temporal summation (p = 0.0382). Both dispositional traits and radiographic KOA scores independently and combined were predictive of Graded Chronic Pain Scale pain and function, and Western Ontario and McMaster University pain and function (ps ⩽ 0.01). Improvements in R² were noted across all models with the inclusion of dispositional traits.

Conclusion: Consideration of dispositional traits reduces the variability between radiographic KOA and pain and function. Non-pathological and associated pain-related psychological factors and dispositional traits might serve as parsimonious proxy tools to improve clinical assessments.

Registration: N/A.

Keywords: Kellgren–Lawrence scores; dispositional traits; function; knee osteoarthritis; pain.

Plain language summary

Dispositional traits help explain individual differences in relationships between a radiographic knee osteoarthritis measure, pain, and physical function Significance • The concordance between radiographic knee osteoarthritis and experimental and clinical pain is conflicting. • Dispositional traits comprise the infrastructure from which an individual interprets and interacts with the environment and are predictive of sensory sensitivity, response to stress, psychopathology, and behavior. • Consideration of dispositional traits improves the congruence between knee osteoarthritis Kellgren-Lawrence scores, experimental pain, and clinical pain.