Quintero Daniel, Jahn Jacob, Jose Jean, Kholodovsky Eric, Travis Levi M, Costello Ii Joseph P, Perez Olivia, Caban-Martinez Alberto J, Best Thomas M
Department of Orthopedics, Division of Sports Medicine, UHealth Sports Medicine Institute, Miami, Florida, United States of America.
Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
PLoS One. 2025 Aug 4;20(8):e0329741. doi: 10.1371/journal.pone.0329741. eCollection 2025.
Ethnicity is associated with varying reporting of pain, coping mechanisms, and disease severity in patients with knee osteoarthritis (KOA). However, few studies have evaluated its importance in ethnicity, particularly the Hispanic population. This study compares pain intensity (VAS), function (WOMAC), and pain catastrophizing (PCS) between Hispanic (HP) and non-Hispanic White patients (NHWP) stratified by socio-economic status (SES) and osteoarthritis radiographic K-L grade.
A cross-sectional study of patients from a tertiary care clinic between July 2021 and December 2022 was performed. Patients with knee pain, radiographs, and doctor-diagnosis of KOA completed questionnaires in English or Spanish. Descriptive statistics characterized demographic differences between NHWP and HP in VAS, WOMAC, and PCS. Two one-way analyses of variance evaluated the effect of both ethnicity and sex, with subgroup analyses stratifying by K-L grade. Multivariate general linear models assessed primary outcomes while controlling for confounders.
A total of 195 subjects (HP = 145, NHWP = 50) were included. HP exhibited higher VAS, PCS, and WOMAC scores compared to NHWP. PCS was higher in HP (p = 0.004, mean = 8.89) than NHWP (mean = 4.58), as was VAS (p < 0.001, mean = 4.28 vs. 2.74) and WOMAC (p = 0.029, mean = 27.86 vs. 21.58). These differences remained when controlled for NSES and K-L grade. Stratifying by sex and comparing primary outcomes between HP and NHWP, male HP had greater VAS (p = .021, mean = 3.83 vs. 2.42) and PCS (p = .008, mean = 8.83 vs. 3.35), while female HP had greater VAS (p = .019, mean = 4.62 vs. 3.08) and nonsignificantly greater PCS (p = .164, mean = 8.94 vs. 5.92).
HP with KOA reported greater pain severity, functional limitation, and PCS. compared with NHWP, even after adjusting for NSES and K-L grade. Our findings expand on previous reports by including a larger number of HP and analyzing the role of sex, impact of socioeconomic status, and influence of radiographic severity on patient symptoms.
种族与膝关节骨关节炎（KOA）患者疼痛报告、应对机制及疾病严重程度的差异有关。然而，很少有研究评估其在不同种族中的重要性，尤其是西班牙裔人群。本研究比较了按社会经济地位（SES）和骨关节炎放射学K-L分级分层的西班牙裔（HP）和非西班牙裔白人患者（NHWP）之间的疼痛强度（视觉模拟评分法[VAS]）、功能（西安大略和麦克马斯特大学骨关节炎指数[WOMAC]）以及疼痛灾难化（疼痛灾难化量表[PCS]）情况。
对2021年7月至2022年12月期间来自一家三级医疗诊所的患者进行了一项横断面研究。有膝关节疼痛、X光片且经医生诊断为KOA的患者用英语或西班牙语完成问卷。描述性统计描述了NHWP和HP在VAS、WOMAC和PCS方面的人口统计学差异。两项单因素方差分析评估了种族和性别的影响，并按K-L分级进行亚组分析。多变量一般线性模型在控制混杂因素的同时评估主要结局。
共纳入195名受试者（HP = 145，NHWP = 50）。与NHWP相比，HP的VAS、PCS和WOMAC评分更高。HP的PCS（p = 0.004，均值 = 8.89）高于NHWP（均值 = 4.58），VAS（p < 0.001，均值 = 4.28对2.74）和WOMAC（p = 0.029，均值 = 27.86对21.58）也是如此。在控制了NSES和K-L分级后，这些差异仍然存在。按性别分层并比较HP和NHWP之间的主要结局，男性HP的VAS（p = 0.021，均值 = 3.83对2.42）和PCS（p = 0.008，均值 = 8.83对3.35）更高，而女性HP的VAS（p = 0.019，均值 = 4.62对3.08）更高，PCS虽有升高但无统计学意义（p = 0.164，均值 = 8.94对5.92）。
患有KOA的HP报告的疼痛严重程度、功能受限和PCS更高。与NHWP相比，即使在调整了NSES和K-L分级之后也是如此。我们的研究结果扩展了先前的报告，纳入了更多的HP，并分析了性别作用、社会经济地位的影响以及放射学严重程度对患者症状的影响。
