Changes in the structural features of osteoarthritis in a year of weight loss

Jafarzadeh, S. Reza; Clancy, Margaret; Li, J.-S.; Apovian, Caroline M.; Guermazi, Ali; Eckstein, F.; Felson, David T.

doi:10.1016/j.joca.2018.03.003

Cited by 21 publications

(39 citation statements)

References 20 publications

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“…The studies assessed structural changes in the joint focusing on different pathologies (Table II). Three studies also looked at changes in clinical symptoms in relation to structural pathologies 22,23,30 . Because the pathologies assessed and OMIs varied markedly, we focused on describing the studies with qualitative synthesis of their results rather than performing a quantitative synthesis.…”

Section: Effect Of Weight Lossmentioning

confidence: 99%

“…Another study 28 based on the OAI found at 96-months follow-up no significant differences in WORMS sum score between groups in the rate of change of global knee cartilage score or cartilage score for each compartment. One study 30 assessed cartilage using the MRI Osteoarthritis Knee Score (MOAKS) 35 and found no significant change between groups.…”

Section: Articular Cartilagementioning

confidence: 99%

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The effects of weight loss on imaging outcomes in osteoarthritis of the hip or knee in people who are overweight or obese: a systematic review

Daugaard

Hangaard

Bartels

et al. 2020

Osteoarthritis and Cartilage

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Objective: To evaluate the structural effects of weight loss on hip or knee osteoarthritis (OA) and to summarize which structural joint pathologies have been examined and the evidence for the outcome measurement instruments applied. Design: Based on a pre-specified protocol (available: PROSPERO CRD42017065263), we conducted a systematic search of the bibliographic databases, Medline, Embase and Web of Science identifying longitudinal articles reporting the effects of weight loss on structural imaging outcomes in OA of the hip or knee in people who are overweight or obese. Results: From 1625 potentially eligible records, 14 articles (from 6 cohorts) were included. 2 cohorts were derived from RCTs. Evaluated pathologies were: articular cartilage (n ¼ 7), joint space width (n ¼ 3), bone marrow lesions (n ¼ 5), synovitis (n ¼ 2), effusion (n ¼ 1), meniscus (n ¼ 3), bone marrow density (n ¼ 1) and infrapatellar fat pad (IPFP; n ¼ 2). Cartilage showed conflicting results when evaluating cartilage thickness by direct thickness measurements. Compositional dGEMRIC and T2 mapping measures in early knee OA showed trends towards reduced cartilage degeneration. Joint space width on conventional radiographs showed no change. Weight loss reduced the size of the IPFP. Synovitis and effusion were not affected. Following weight loss DXA showed bone loss at the hip. Conclusion: We did not find consistent evidence of the effects of weight loss on OA structural pathology in people who are overweight or obese. There is a need to achieve consensus on which structural pathologies and measurements to apply in weight loss and OA research.

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Section: Effect Of Weight Lossmentioning

confidence: 99%

Section: Articular Cartilagementioning

confidence: 99%

The effects of weight loss on imaging outcomes in osteoarthritis of the hip or knee in people who are overweight or obese: a systematic review

Daugaard

Hangaard

Bartels

et al. 2020

Osteoarthritis and Cartilage

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show abstract

“…Another study found that substantial weight loss over 12 months was protective on the biochemical composition of cartilage (dGEMRIC) and reduced cartilage thickness losses 16 . Others did not find differences in bone marrow lesions (BMLs), synovitis and cartilage damage and thickness between subjects with (!20%) and without weight loss 18 . Weight change studies in populations that included only subjects without clinical knee OA at baseline are scarce.…”

Section: Introductionmentioning

confidence: 96%

Effect of weight change on progression of knee OA structural features assessed by MRI in overweight and obese women

Landsmeer

Vos

Plas³

et al. 2018

Osteoarthritis and Cartilage

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“…In an earlier study, we assessed cartilage both semiquantitatively and quantitatively in the same study sample and reported no effect of weight loss on this measure over a year, although morphologic changes in cartilage would be unusual in this time frame. BMLs and synovitis have both been shown to change within a few weeks .…”

Section: Discussionmentioning

confidence: 99%

Mediating Role of Bone Marrow Lesions, Synovitis, Pain Sensitization, and Depressive Symptoms on Knee Pain Improvement Following Substantial Weight Loss

Jafarzadeh

Neogi

Stefanik

et al. 2020

Arthritis & Rheumatology

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Objective Massive weight loss leads to marked knee pain reduction in individuals with knee pain, but the reason for the reduction in pain is unknown. This study was undertaken to quantify the contribution of magnetic resonance imaging (MRI)–evidenced changes in pain‐sensitive structures, bone marrow lesions (BMLs), and synovitis, and changes in pain sensitization or depressive symptoms, to knee pain improvement after substantial weight loss. Methods Morbidly obese patients with knee pain on most days were evaluated before bariatric surgery or medical weight management and at 1‐year follow‐up for BMLs and synovitis seen on MRI, the pressure pain threshold (PPT) at the patella and the right wrist, depressive symptoms (using the Center for Epidemiologic Studies Depression scale [CES‐D]), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain survey. Natural‐effects models were used to quantify the extent that achieving a minimum clinically important difference (MCID) of ≥18% on the WOMAC pain scale could be mediated by weight loss–induced changes in BMLs, synovitis, PPT, and depressive symptoms. Results Of 75 participants, 53.3% lost ≥20% of weight by 1 year. Of these, 75% attained the MCID for pain improvement, compared with 34.3% in those who had <20% weight loss. Mediation analyses suggested that, in those with at least 20% weight loss, the odds of pain improvement increased by 62%, 15%, and 22% through changes in patella PPT, wrist PPT, and CES‐D, respectively, but pain improvement was not mediated by MRI changes in BMLs or synovitis. Conclusion Weight loss–induced knee pain improvement is partially mediated by changes in pain sensitization and depressive symptoms but is independent of MRI changes in BMLs and synovitis.

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Changes in the structural features of osteoarthritis in a year of weight loss

Abstract: In middle-aged persons with mostly mild radiographic OA, structural features changed little over a year and weight loss was not associated with effects on structural changes.

Cited by 21 publications

References 20 publications

The effects of weight loss on imaging outcomes in osteoarthritis of the hip or knee in people who are overweight or obese: a systematic review

The effects of weight loss on imaging outcomes in osteoarthritis of the hip or knee in people who are overweight or obese: a systematic review

Effect of weight change on progression of knee OA structural features assessed by MRI in overweight and obese women

Mediating Role of Bone Marrow Lesions, Synovitis, Pain Sensitization, and Depressive Symptoms on Knee Pain Improvement Following Substantial Weight Loss

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