{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:10:35Z","timestamp":1790691035692,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>The purpose of this study was to identify 12\u2010month postinjection knee osteoarthritis (KOA) pain trajectories and develop an early prediction model using patient\u2010reported pain scores. Data were derived from a multi\u2010site, single\u2010blind randomized controlled trial of intra\u2010articular injections for KOA. The primary analysis focused on participants assigned to autologous bone marrow aspirate concentrate, umbilical cord tissue\u2010derived mesenchymal stromal cells, or stromal vascular fraction. After data\u2010quality screening, the primary trajectory cohort included 317 participants and the prediction cohort included 295 participants with Screening and Month\u20103 KOOS\u201012 Pain scores. Latent class mixed\u2010effects modeling identified a two\u2010class solution selected for clinical interpretability: 66.6% of patients followed an Improved Pain trajectory and 33.4% followed a Persistent Pain trajectory. Although a three\u2010class model had slightly lower BIC, the additional class included only 2.5% of participants and was not retained for the clinical prediction tool. A logistic regression model using KOOS\u201012 Pain at Screening and 3\u2010month change predicted trajectory membership with AUC\u2009=\u20090.785 in training and AUC\u2009=\u20090.792 in the held\u2010out test set. A training\u2010selected threshold of 0.656 yielded held\u2010out test sensitivity\u2009=\u20090.790, specificity\u2009=\u20090.692, PPV\u2009=\u20090.860, NPV\u2009=\u20090.581, and accuracy\u2009=\u20090.761. The resultant model was implemented as the Symptom Prediction for Outcomes of Treatment (SPOT) web calculator. Clinical Significance: The SPOT web calculator only requires KOOS\u201012 Pain data from Screening and Month 3 to classify patients as likely to follow an Improved Pain vs. Persistent Pain trajectory after orthobiologic KOA treatment.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT03818737\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jor.70270","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:50:59Z","timestamp":1788184259000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["SPOT: An Early Detection Tool for Predicting Pain Trajectories Following Intra\u2010Articular Injections"],"prefix":"10.1002","volume":"44","author":[{"given":"Brittany L.","family":"Nelson","sequence":"first","affiliation":[{"name":"Emory Sports Performance And Research Center (SPARC) Flowery Branch Georgia USA"},{"name":"Emory Human Performance Institute Atlanta Georgia USA"},{"name":"Department of Orthopaedics Emory University School of Medicine Atlanta Georgia USA"},{"name":"Center for Medical Ethics and Health Policy Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6209-5410","authenticated-orcid":false,"given":"Prathap","family":"Jayaram","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Boden","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8458-0126","authenticated-orcid":false,"given":"Kenneth","family":"Mautner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0487-201X","authenticated-orcid":false,"given":"Michael B.","family":"Gottschalk","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-8422","authenticated-orcid":false,"given":"Gregory D.","family":"Myer","sequence":"additional","affiliation":[{"name":"Emory Sports Performance And Research Center (SPARC) Flowery Branch Georgia USA"},{"name":"Emory Human Performance Institute Atlanta Georgia USA"},{"name":"Department of Orthopaedics Emory University School of Medicine Atlanta Georgia USA"},{"name":"Department of Veterans Affairs Atlanta VA Medical Center Decatur Georgia USA"},{"name":"Wallace H. 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