Why walking causes different amounts of knee pain in people with osteoarthritis
Individual Differences in Gait and Osteoarthritis Pain
This project will see if differences in the brain, joint imaging, movement, and sensory responses explain why adults 45–80 with knee osteoarthritis have different levels of walking pain.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 300 (estimated) |
| Ages | 45 Years to 80 Years |
| Sex | All |
| Sponsor | University of Pittsburgh Academic / other |
| Locations | 1 site (Pittsburgh, Pennsylvania) |
| Trial ID | NCT07308873 on ClinicalTrials.gov |
What this trial studies
This observational study will enroll 300 adults with knee osteoarthritis and collect detailed biopsychosocial data across two in-person visits. Participants will complete surveys, physical function and exercise tasks, knee X-ray and MRI, non-invasive brain imaging, biomechanics during mobility, and sensory testing. Researchers will use advanced analyses to link neural, joint, biomechanical, and psychosocial factors to movement-evoked pain and walking limitations. The overarching hypothesis is that central neural processes, together with peripheral and psychosocial factors, help explain why some people have severe disabling pain despite similar joint degeneration.
Who should consider this trial
Good fit: Adults 45–80 with chronic (≥6 months) moderate-to-severe knee osteoarthritis pain (greater than 3/10 on more than half of days) and radiographic KL grade 2–4 are the ideal candidates.
Not a fit: People with inflammatory arthritis, another dominant chronic pain condition (e.g., fibromyalgia), significant neurologic lower-extremity pain or weakness, acute pain that is worse than their knee OA, or routine use of >15 mg oral morphine equivalents per day are unlikely to benefit or be eligible.
Why it matters
Potential benefit: If successful, the results could point to new targets to improve rehabilitation and keep people with knee OA more active and less disabled.
How similar studies have performed: Previous research has linked brain and sensory changes to osteoarthritis pain, but this large, multimodal effort focused specifically on walking-evoked pain is relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Knee pain for greater than 6 months. * Moderate-to-severe knee pain (\>3/10) due to osteoarthritis, as defined by American College of Rheumatology and EULAR diagnostic criteria, on \>50% of days in the past month. * KL grade 2-4 indicating significant degenerative changes on knee X-ray. * 45-80 years old Exclusion Criteria: * Inflammatory arthritis (e.g. rheumatoid arthritis). * More intense pain due to another chronic pain syndrome (e.g. fibromyalgia, hip osteoarthritis) * Significant pain or weakness in the lower extremities due to a neurological condition (e.g. lumbar radiculopathy, paresis due to stroke) * Acute pain that is more intense than knee osteoarthritis pain * Current routine use of more than 15 mg oral morphine equivalents per day (use of \<15 mg OME does not exclude the participant). * Recent new medication, exercise, behavioral, or complementary and integrative treatment started in the last month. Stable use of these treatments for greater than 1 month does not exclude the participant. * Recent intra-articular injection of steroid or other agent (greater than 1 month does not exclude the participant) * Recent knee radiofrequency ablation (greater than 3 months does not exclude the participant) * Recent knee arthroscopic surgery (greater than 3 months does not exclude the participant) * History of knee replacement or open knee surgery on the index knee, defined as the more painful knee on average over the last month. * Inability to walk or climb stairs without significant assistance (e.g. a one-person assist, use a wheel chair; however, the use of a cane does not exclude the participant). * Inability to participate in study procedures (e.g. cognitive impairment limiting ability to understand directions, inability to understand and read English) * Uncontrolled or unstable medical disorder preventing participation in study procedures * History of brain surgery * Tattoos on sensory testing sites * Pregnancy * Breastfeeding * Inability to under knee MRI scan due to incompatible devices or foreign bodies.
Where this trial is running
Pittsburgh, Pennsylvania
- UPMC Pain Medicine at Centre Commons — Pittsburgh, Pennsylvania, United States (Recruiting)
Study contacts
- Principal investigator: Benedict Alter, MD, PhD — University of Pittsburgh
- Study coordinator: Benedict Alter, MD, PhD
- Email: bea51@pitt.edu
- Phone: 412-665-8052
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.