Dolor en la Artrosis de Rodilla

C. Alejandro Álvarez López; Sergio Ricardo Soto-Carrasco; Yenima de la Caridad García Lorenzo

doi:10.1055/s-0039-1698796

Revista Chilena de Ortopedia y Traumatología, Table of Contents

CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2019; 60(03): 106-111
DOI: 10.1055/s-0039-1698796

Review Article | Artículo de Revisión

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Dolor en la Artrosis de Rodilla

Pain in Knee Osteoarthritis

C. Alejandro Álvarez López

¹Doctorado en Artroscopia de la Rodilla, Máster en Urgencias Médicas, Especialista en Ortopedia y Traumatología, Profesor Titular, Hospital Universitario Manuel Ascunce Domenech, Investigador auxiliar del CITMA, Universidad de Ciencias Médicas, Camagüey, Cuba

,

Sergio Ricardo Soto-Carrasco

²Médico cirujano, Asociación Chilena de Seguridad (ACHS), Chillán, Chile

,

Yenima de la Caridad García Lorenzo

³Especialista en Medicina General Integral, Profesor Asistente, Policlínico Universitario Tula Aguilera, Universidad de Ciencias Médicas, Camagüey, Cuba

› Author Affiliations

Abstract

Resumen

El dolor constituye el síntoma fundamental de la artrosis, sus características e interpretación permiten el diagnóstico certero y también conocer la magnitud de esa entidad. El objetivo de este trabajo, es profundizar los conocimientos sobre los elementos más esenciales relacionados con el dolor en la artrosis de la rodilla. Se describen las causas mecánicas y bioquímicas del dolor, entre las que resaltan el dolor óseo, sinovial, así como los factores bioquímicos relacionados con ese síntoma. Se hace referencia a las principales estructuras anatómicas responsables del dolor y sus mecanismos de acción. Se mencionan la relación existente entre ese síntoma y las modalidades imagenológicas, así como los patrones del dolor. Para finalizar, se hace referencia a las escalas de dolor usadas.

Abstract

Pain is the main symptom of osteoarthritis. Determining the distinctive features of pain in knee osteoarthritis allows for an accurate diagnosis. This article gives a review of the results from research work on the typical features of knee osteoarthritic pain. The mechanics and biochemical causes of pain are described including both bone and synovial biochemical symptom-related factors. The relationships between knee pain, various imaging techniques and pain mechanism are also identified. Finally, the used pain scales are presented.

Palabras clave

artrosis rodilla - dolor rodilla - imagenología artrosis

Keywords

knee osteoarthritis - knee pain - imaging osteoarthritis

Full Text

References

Bibliografía
1 Abdel-Aziem AA, Soliman ES, Mosaad DM, Draz AH. Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities. J Phys Ther Sci 2018; 30 (02) 307-312
2 Cottam WJ, Iwabuchi SJ, Drabek MM, Reckziegel D, Auer DP. Altered connectivity of the right anterior insula drives the pain connectome changes in chronic knee osteoarthritis. Pain 2018; 159 (05) 929-938
3 Ebell MH. Osteoarthritis: rapid evidence review. Am Fam Physician 2018; 97 (08) 523-526
4 Walton DM, Elliott JM. A new clinical model for facilitating the development of pattern recognition skills in clinical pain assessment. Musculoskelet Sci Pract 2018; 36 (36) 17-24
5 Tran J, Peng PWH, Lam K, Baig E, Agur AMR, Gofeld M. Anatomical study of the innervation of anterior knee joint capsule: implication for image-guided intervention. Reg Anesth Pain Med 2018; 43 (04) 407-414
6 Taylor N. Nonsurgical management of osteoarthritis knee pain in the older adult. Clin Geriatr Med 2017; 33 (01) 41-51
7 Treatment of osteoarthritis of the knee. Evidence based guideline. 2 nd ed. American Academy of Orthopaedic Surgeons. 2013 :8–10.
8 Eberly L, Richter D, Comerci G. , et al. Psychosocial and demographic factors influencing pain scores of patients with knee osteoarthritis. PLoS One 2018; 13 (04) e0195075
9 Holden MA, Whittle R, Healey EL. , et al. Content and evaluation of the benefits of effective exercise for older adults with knee pain trial physiotherapist training program. Arch Phys Med Rehabil 2017; 98 (05) 866-873
10 Kim GJ, Choi J, Lee S, Jeon C, Lee K. The effects of high intensity laser therapy on pain and function in patients with knee osteoarthritis. J Phys Ther Sci 2016; 28 (11) 3197-3199
11 Gwilym SE, Pollard TCB, Carr AJ. Understanding pain in osteoarthritis. J Bone Joint Surg Br 2008; 90 (03) 280-287
12 Harden RN, Saracoglu M, Connolly S. , et al. “Managing” the placebo effect: the single-blind placebo lead-in response in two pain models. Pain Med 2016; 17 (12) 2305-2310
13 Vaishya R, Pandit R, Agarwal AK, Vijay V. Intra-articular hyaluronic acid is superior to steroids in knee osteoarthritis: A comparative, randomized study. J Clin Orthop Trauma 2017; 8 (01) 85-88
14 Bobić Lucić L, Grazio S. Impact of balance confidence on daily living activities of older people with knee osteoarthritis with regard to balance, physical function, pain, and quality of life: a preliminary report. Clin Gerontol 2018; 41 (04) 357-365
15 Thakral M, Shi L, Foust JB. , et al. Pain quality descriptors in community-dwelling older adults with nonmalignant pain. Pain 2016; 157 (12) 2834-2842
16 Garg Y, Singh J, Sohal HS, Gore R, Kumar A. Comparison of clinical effectiveness and safety of newer nonsteroidal anti-inflammatory drugs in patients of osteoarthritis of knee joint: a randomized, prospective, open-label parallel-group study. Indian J Pharmacol 2017; 49 (05) 383-389
17 Luz-Santos C, Ribeiro Camatti J, Barbosa Paixão A. , et al. Additive effect of tDCS combined with Peripheral Electrical Stimulation to an exercise program in pain control in knee osteoarthritis: study protocol for a randomized controlled trial. Trials 2017; 18 (01) 609
18 Salamh P, Cook C, Reiman MP, Sheets C. Treatment effectiveness and fidelity of manual therapy to the knee: A systematic review and meta-analysis. Musculoskelet Care 2017; 15 (03) 238-248
19 Conaghan PG, Hunter DJ, Cohen SB. , et al; FX006-2014-008 Participating Investigators. Effects of a single intra-articular injection of a microsphere formulation of triamcinolone acetonide on knee osteoarthritis pain: a double-blinded, randomized, placebo-controlled, multinational study. J Bone Joint Surg Am 2018; 100 (08) 666-677
20 da Costa BR, Hari R, Jüni P. Intra-articular corticosteroids for osteoarthritis of the knee. JAMA 2016; 316 (24) 2671-2672
21 Ismail A, Moore C, Alshishani N, Yaseen K, Alshehri MA. Cognitive behavioural therapy and pain coping skills training for osteoarthritis knee pain management: a systematic review. J Phys Ther Sci 2017; 29 (12) 2228-2235
22 Yoon J, Kanamori A, Fujii K, Isoda H, Okura T. Evaluation of maslinic acid with whole-body vibration training in elderly women with knee osteoarthritis. PLoS One 2018; 13 (03) e0194572
23 Laires PA, Laíns J, Miranda LC. , et al. Inadequate pain relief among patients with primary knee osteoarthritis. Rev Bras Reumatol Engl Ed 2017; 57 (03) 229-237
24 MacFarlane LA, Yang H, Collins JE. , et al. Associations among meniscal damage, meniscal symptoms and knee pain severity. Osteoarthritis Cartilage 2017; 25 (06) 850-857
25 Zacaron KAM, da Silva Mendes N, , E Silva YC, Lucchetti G. Effects of laying on of hands with and without a spiritual context on pain and functionality of older women with knee osteoarthritis: study protocol for a randomized controlled trial. J Integr Med 2018; 16 (02) 106-112
26 Gutiérrez-Gómez JJ, Santillán-Barrera E, Velasco-Legoff C, Chávez-Espina LM, Torres-Roldán F, Aldrete-Velasco J. [Multidisciplinary meeting on application techniques for restitution of synovial fluid in patients with knee arthritis: update]. Acta Ortop Mex 2017; 31 (06) 319-327
27 Kuntz AB, Chopp-Hurley JN, Brenneman EC. , et al. Efficacy of a biomechanically-based yoga exercise program in knee osteoarthritis: A randomized controlled trial. PLoS One 2018; 13 (04) e0195653
28 Wang Y, Lombard C, Hussain SM. , et al. Effect of a low-intensity, self-management lifestyle intervention on knee pain in community-based young to middle-aged rural women: a cluster randomised controlled trial. Arthritis Res Ther 2018; 20 (01) 74
29 Dimitroulas T, Lambe T, Klocke R, Kitas GD, Duarte RV. Biologic drugs as analgesics for the management of osteoarthritis. Semin Arthritis Rheum 2017; 46 (06) 687-691
30 Hamdi A, Albaghdadi AT, Ghalimah B, Alnowiser A, Ahmad A, Altaf A. Bariatric surgery improves knee function and not knee pain in the early postoperative period. J Orthop Surg Res 2018; 13 (01) 82
31 Hagen KB, Grotle M. Critically Appraised Papers: Moderate-intensity walking for people with severe knee osteoarthritis does not decrease pain but may have cardiovascular benefits [synopsis]. J Physiother 2018; 64 (02) 123
32 Kim MK, Ha CW, In Y. , et al. A multicenter, double-blind, phase III clinical trial to evaluate the efficacy and safety of a cell and gene therapy in knee osteoarthritis patients. Hum Gene Ther Clin Dev 2018; 29 (01) 48-59
33 Owens C, Conaghan PG. Improving joint pain and function in osteoarthritis. Practitioner 2016; 260 (1799): 17-20
34 Eckstein F, Guermazi A, Gold G. , et al. Imaging of cartilage and bone: promises and pitfalls in clinical trials of osteoarthritis. Osteoarthritis Cartilage 2014; 22 (10) 1516-1532
35 Bastick AN, Belo JN, Runhaar J, Bierma-Zeinstra SM. What are the prognostic factors for radiographic progresión of knee osteoarthritis: A meta analysis. Clin Orthop Relat Res 2015; 473 (09) 2969-2989
36 Salaffi F, Ciapetti A, Carotti M. The sources of pain in osteoarthritis: a pathophysiological review. Reumatismo 2014; 66 (01) 57-71
37 Fernandes GS, Parekh SM, Moses J. , et al. Prevalence of knee pain, radiographic osteoarthritis and arthroplasty in retired professional footballers compared with men in the general population: a cross-sectional study. Br J Sports Med 2018; 52 (10) 678-683
38 Sheehy L, Culham E, McLean L. , et al. Validity and sensitivity to change of three scales for the radiographic assessment of knee osteoarthritis using images from the Multicenter Osteoarthritis Study (MOST). Osteoarthritis Cartilage 2015; 23 (09) 1491-1498
39 Li Q, Amano K, Link TM, Ma CB. Advanced imaging in osteoarthritis. Sports Health 2016; 8 (05) 418-428
40 Schwaiger BJ, Gersing AS, Mbapte Wamba J, Nevitt MC, McCulloch CE, Link TM. Can signal abnormalities detected with MR imaging in knee articular cartilage be used to predict development of morphologic cartilage defects? 48 month data from the osteoarthritis initiative. Radiology 2016; 281 (01) 158-167
41 Farpour HR, Fereydooni F. Comparative effectiveness of intra-articular prolotherapy versus peri-articular prolotherapy on pain reduction and improving function in patients with knee osteoarthritis: A randomized clinical trial. Electron Physician 2017; 9 (11) 5663-5669
42 Taheri P, Vahdatpour B, Asl MM, Ramezanian H. Effects of taping on pain and functional outcome of patients with knee osteoarthritis: a pilot randomized single-blind clinical trial. Adv Biomed Res 2017; 6 (06) 139
43 Lee MC, Saleh R, Achuthan A. , et al. CCL17 blockade as a therapy for osteoarthritis pain and disease. Arthritis Res Ther 2018; 20 (01) 62
44 Rafanan Jr BS, Valdecañas BF, Lim BP. , et al. Consensus recommendations for managing osteoarthritic pain with topical NSAIDs in Asia-Pacific. Pain Manag 2018; 8 (02) 115-128
45 Hart HF, Barton CJ, Khan KM, Riel H, Crossley KM. Is body mass index associated with patellofemoral pain and patellofemoral osteoarthritis? A systematic review and meta-regression and analysis. Br J Sports Med 2017; 51 (10) 781-790
46 Sibille KT, Chen H, Bartley EJ. , et al. Accelerated aging in adults with knee osteoarthritis pain: consideration for frequency, intensity, time, and total pain sites. Pain Rep 2017; 2 (03) e591
47 El-Hakeim EH, Elawamy A, Kamel EZ. , et al. Fluoroscopic guided radiofrequency of genicular nerves for pain alleviation in chronic knee osteoarthritis: a single-blind randomized controlled trial. Pain Physician 2018; 21 (02) 169-177
48 Abdalbary SA. Ultrasound with mineral water or aqua gel to reduce pain and improve the WOMAC of knee osteoarthritis. Future Sci OA 2016; 2 (01) FSO110
49 Salazar-Guzmán I, Garfias-Rosas J, Butze-Rangel W. [Comparison of the clinical response to the application of Hylan G-F 20 and collagen-PVP in patients with knee osteoarthritis]. Acta Ortop Mex 2017; 31 (06) 283-286
50 Lee M, Yoo J, Kim JG. , et al. A randomized, multicenter, phase III trial to evaluate the efficacy and safety of polmacoxib compared with celecoxib and placebo for patients with osteoarthritis. Clin Orthop Surg 2017; 9 (04) 439-457
51 Gregori D, Giacovelli G, Minto C. , et al. Association of pharmacological treatments with long-term pain control in patients with knee osteoarthritis: a systematic review and meta-analysis. JAMA 2018; 320 (24) 2564-2579
52 Li JS, Tsai TY, Clancy MM, Li G, Lewis CL, Felson DT. Weight loss changed gait kinematics in individuals with obesity and knee pain. Gait Posture 2019; 68: 461-465
53 Dworkin RH, Turk DC, Peirce-Sandner S. , et al. Meta-analysis of assay sensitivity and study features in clinical trials of pharmacologic treatments for osteoarthritis pain. Arthritis Rheumatol 2014; 66 (12) 3327-3336
54 Gallagher B, Tjoumakaris FP, Harwood MI, Good RP, Ciccotti MG, Freedman KB. Chondroprotection and the prevention of osteoarthritis progression of the knee: a systematic review of treatment agents. Am J Sports Med 2015; 43 (03) 734-744