Published 29 September 2009, doi:10.1136/bmj.b3978
Cite this as: BMJ 2009;339:b3978

Letters

Interventions and knee pain

When knee pain is not osteoarthritis

The first 150 words of the full text of this article appear below.

Jenkinson and colleagues show that a simple dietary and exercise intervention has positive effects on knee pain.¹ Over half of their unselected group, however, did not have radiological evidence of osteoarthritis. This shows that practitioners should always consider intra-articular and periarticular soft tissue problems and referred pain from other musculoskeletal regions. This large group might have a range of potentially self limiting soft tissue disorders skewing the observed improvements. This could be determined by interim analysis of WOMAC pain scores and functioning in those with low Kellgren-Lawrence scores at six or 12 months, thus identifying the characteristics of a better prognostic group.

In such a varied group, how is a poorer prognostic group defined? The authors have previously examined the role of muscle power and knee pain,² muscle strength being significantly higher in the exercise group, although baseline values were not presented.³ Higher WOMAC pain scores and lower muscle strength . . . [Full text of this article]

¹ Centre for Rheumatic Diseases, Glasgow Royal Infirmary, Glasgow G4 0SF

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