TNF and Obesity: The results suggest that there is a close relationship between risk factors among internationally-approved pain-related clinical outcome measures including obesity, abnormal biochemical parameters such as IL-10, TNF-α, CRP, CK-MM, and Aldo A, deranged lower anatomical measurements, and KL grading scales to detect cost-effective diagnostic protocol for LHD-KOA in comparison with conventional costly diagnostic imaging such as X-ray, MRI, CT scan, or EMG.