# Ethnic differences in pain, function, and catastrophizing in South Florida adults with knee osteoarthritis

## TL;DR

Hispanic patients with knee osteoarthritis report more pain, worse function, and higher pain catastrophizing than non-Hispanic White patients, even after adjusting for socioeconomic status and disease severity.

## Contribution

The study expands on previous findings by including a larger Hispanic cohort and analyzing the influence of sex, socioeconomic status, and radiographic severity.

## Key findings

- Hispanic patients had significantly higher pain intensity, functional limitation, and pain catastrophizing scores than non-Hispanic White patients.
- These differences remained significant even after adjusting for socioeconomic status and radiographic severity.
- Male and female Hispanic patients both reported higher pain severity compared to non-Hispanic White patients.

## Abstract

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.