Neuropathic pain in knee osteoarthritis: functional burden beyond cartilage thickness—a cross-sectional study

Sixty patients with knee OA were evaluated and classified into NP and non-NP groups using the painDETECT questionnaire (30 per group). Compared with non-NP patients, those with NP reported significantly higher pain scores (VAS: 4.70 vs. 3.37, p < 0.001), worse functional impairment (WOMAC: 71.0 vs. 55.9, p = 0.002), and lower quality of life across several SF-36 domains, particularly Role Emotional (p = 0.004) and Bodily Pain (p < 0.001). Femoral cartilage thickness at the medial condyle, intercondylar area, and lateral condyle did not differ significantly between groups. Trends toward higher obesity, more physically demanding occupations, and greater Kellgren-Lawrence severity were observed among NP patients. These findings suggest that NP adversely influences pain and function in knee OA independent of cartilage thickness, underscoring the importance of early identification and targeted management.