Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2017; 8(3): 278-285
Published online Mar 18, 2017. doi: 10.5312/wjo.v8.i3.278
Relationship between biological factors and catastrophizing and clinical outcomes for female patients with knee osteoarthritis
Tatsunori Ikemoto, Hirofumi Miyagawa, Yukiko Shiro, Young-Chang Park Arai, Machiko Akao, Kenta Murotani, Takahiro Ushida, Masataka Deie
Tatsunori Ikemoto, Hirofumi Miyagawa, Young-Chang Park Arai, Takahiro Ushida, Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
Yukiko Shiro, Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Seto, Aichi 480-1298, Japan
Machiko Akao, Masataka Deie, Department of Orthopedic Surgery, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
Kenta Murotani, Division of Biostatistics, Clinical Research Center Aichi Medical University, Nagakute 480-1195, Japan
Author contributions: Ikemoto T had conceived this research; Ikemoto T and Miyagawa H contributed equally to this work; Ikemoto T, Ushida T and Deie M did the research design; Ikemoto T, Miyagawa H and Akao M participated in the collection of the data; Ikemoto T, Shiro Y, Murotani K and Arai YCP contributed to the analysis and interpretation of the data; Ikemoto T, Shiro Y and Arai YCP prepared a first manuscript and a revised manuscript.
Institutional review board statement: The study received ethical approval from the Research Ethics Committee of Aichi Medical University, Japan (No. 12-101).
Informed consent statement: Prior to study enrollment, each subject was fully informed by the investigator 1: that content of this study and 2: that the personal information of the subject would be kept confidential.
Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this paper.
Data sharing statement: There are no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tatsunori Ikemoto, MD, PhD, Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, 1-1 yazako karimata, Nagakute, Aichi 480-1195, Japan. tatsunon31-ik@umin.ac.jp
Telephone: +81-561-611809 Fax: +81-561-625004
Received: October 13, 2016
Peer-review started: October 19, 2016
First decision: November 14, 2016
Revised: November 27, 2016
Accepted: December 13, 2016
Article in press: December 14, 2016
Published online: March 18, 2017

To investigate the correlations between clinical outcomes and biopsychological variables in female patients with knee osteoarthritis (OA).


Seventy-seven patients with symptomatic knee OA were enrolled in this study. We investigated the age, body mass index (BMI), pain catastrophizing scale (PCS) and radiographic severity of bilateral knees using a Kellgren-Lawrence (K-L) grading system of the subjects. Subsequently, a multiple linear regression was conducted to determine which variables best correlated with main outcomes of knee OA, which were pain severity, moving capacity by measuring timed-up-and-go test and Japanese Knee Osteoarthritis Measure (JKOM).


We found that the significant contributor to pain severity was PCS (β = 0.555) and BMI (β = 0.239), to moving capacity was K-L grade (β = 0.520) and to PCS (β = 0.313), and to a JKOM score was PCS (β = 0.485) and K-L grade (β = 0.421), respectively.


The results suggest that pain catastrophizing as well as biological factors were associated with clinical outcomes in female patients with knee OA, irrespective of radiographic severity.

Keywords: Osteoarthritis, Pain catastrophizing, Knee pain, Physical function, Japanese Knee Osteoarthritis Measure

Core tip: Plenty of previous studies have focused on biological factors such as aging, gender, body mass index, ethnicity and history of knee injury for knee pain in cases where there was a discordant relationship between radiographic severity and symptoms in knee osteoarthritis (OA). However, in the present study, we found that pain catastrophizing thought was highly associated with knee-related clinical outcomes, irrespective of radiographic severity, for female patients with knee OA, especially pain severity and quality of life.