Obesity and Knee Osteoarthritis

Felson, David T.; Anderson, Jennifer J.; Naimark, A; Walker, Alexander M.; Meenan, Robert F.

doi:10.7326/0003-4819-109-1-18

Cited by 988 publications

(565 citation statements)

References 13 publications

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“…Given the strong evidence linking obesity and knee OA (1,(11)(12)(13)(14)(15)(16), our approach involving measurement of the association between change in body mass (i.e., weight loss) and changes in knee-joint forces and knee-joint moments clarifies the pathophysiologic process. By adjusting statistically for age, sex, and baseline covariates including walking velocity, this analysis isolated the association between weight loss and changes in knee-joint kinetics.…”

Section: Discussionmentioning

confidence: 99%

“…The most important modifiable risk factor for the development and progression of OA is obesity (1,(10)(11)(12)(13)(14)(15)(16)(17). Weight loss reduces the risk of symptomatic knee OA (13), and for obese patients with knee OA, weight loss and exercise are recommended by both the American College of Rheumatology and the European League Against Rheumatism (18,19).…”

mentioning

confidence: 99%

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Weight loss reduces knee‐joint loads in overweight and obese older adults with knee osteoarthritis

Messier¹,

Gutekunst²,

Davis³

et al. 2005

Arthritis & Rheumatism

456

317

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Objective. To determine the relationship between change in body mass and knee-joint moments and forces during walking in overweight and obese older adults with knee osteoarthritis (OA) following an 18-month clinical trial of diet and exercise.Methods. Data were obtained from 142 sedentary, overweight, and obese older adults with self-reported disability and radiographic evidence of knee OA who underwent 3-dimensional gait analysis. Gait kinetic outcome variables included peak knee-joint forces and peak internal knee-joint moments. Mixed regression models were created to predict followup kinetic values, using followup body mass as the primary explanatory variable. Baseline body mass was used as a covariate, and thus followup body mass was a surrogate measure for change in body mass (i.e., weight loss).Results. There was a significant direct association between followup body mass and peak followup values of compressive force (P ‫؍‬ 0.001), resultant force (P ‫؍‬ 0.002), abduction moment (P ‫؍‬ 0.03), and medial rotation moment (P ‫؍‬ 0.02). A weight reduction of 9.8N (1 kg) was associated with reductions of 40.6N and 38.7N in compressive and resultant forces, respectively. Thus, each weight-loss unit was associated with an ϳ4-unit reduction in knee-joint forces. In addition, a reduction in body weight of 9.8N (1 kg) was associated with a 1.4% reduction (0.496 Nm) in knee abduction moment. Conclusion. Our results indicate that each poundof weight lost will result in a 4-fold reduction in the load exerted on the knee per step during daily activities. Accumulated over thousands of steps per day, a reduction of this magnitude would appear to be clinically meaningful.The precise etiology of osteoarthritis (OA) is unknown; however, several risk factors have been identified, including age (1,2), female sex (3), and both occupational (4,5) and sports-related joint stress (6-9). The most important modifiable risk factor for the development and progression of OA is obesity (1,10-17). Weight loss reduces the risk of symptomatic knee OA (13), and for obese patients with knee OA, weight loss and exercise are recommended by both the American College of Rheumatology and the European League Against Rheumatism (18,19). We have shown that an average weight loss of 5% over 18 months in overweight and obese adults with knee OA results in an 18% improvement in function. When dietary changes are combined with exercise, function improves 24% and is accompanied by a significant improvement in mobility (20).Although obesity is strongly associated with knee OA, some obese but otherwise healthy adults adapt to their excessive weight and subsequently reduce kneejoint torques and possibly knee-joint forces during walking (21). In other obese adults, however, excessive biomechanical joint stress represents one possible pathway for the pathogenesis and progression of knee OA. We hypothesized a significant and direct relationship between weight loss and attenuation of knee-joint forces and moments during walking in overweight and obese older adu...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Weight loss reduces knee‐joint loads in overweight and obese older adults with knee osteoarthritis

Messier¹,

Gutekunst²,

Davis³

et al. 2005

Arthritis & Rheumatism

456

317

View full text Add to dashboard Cite

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“…108 Several longitudinal studies support a role for overweight and obesity in the onset of OA. [109][110][111][112][113] Being overweight at an average age of 37 y increased the risk of developing knee OA at a mean age of 73 y; 109 approximately 25% of subjects normal-weight at baseline developed OA against 50% of overweight subjects. 109 In another recent study, male medical students with a BMI higher than 25 kg/m 2 , between the ages of 20 and 29 y, had a three-fold increased risk of developing symptomatic knee OA by the time they reached age 60 y.…”

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 99%

“…[109][110][111][112][113] Being overweight at an average age of 37 y increased the risk of developing knee OA at a mean age of 73 y; 109 approximately 25% of subjects normal-weight at baseline developed OA against 50% of overweight subjects. 109 In another recent study, male medical students with a BMI higher than 25 kg/m 2 , between the ages of 20 and 29 y, had a three-fold increased risk of developing symptomatic knee OA by the time they reached age 60 y. 113 There are few studies that suggest that weight loss may prevent the development or worsening of knee OA in the elderly; [114][115] most of these studies are not randomized controlled trials and do not provide data for control of potential confounding factors.…”

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 99%

Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5-10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.

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“…Furthermore, obesity has been shown to be a significant risk factor in the development of osteoarthritis, though such association seems to be stronger in knees compared to hips [2][3][4][5][6]. Subsequently, an increasing demand for total hip (THA) or knee arthroplasty (TKA) can be expected among obese patients [7][8][9].…”

mentioning

confidence: 99%

Percent Body Fat More Associated with Perioperative Risks After Total Joint Arthroplasty Than Body Mass Index

Ledford

Thiele

Appleton

et al. 2014

The Journal of Arthroplasty

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Obesity and Knee Osteoarthritis

Abstract: These results and other corroborative cross-sectional data show that obesity or as yet unknown factors associated with obesity cause knee osteoarthritis.

Cited by 988 publications

References 13 publications

Weight loss reduces knee‐joint loads in overweight and obese older adults with knee osteoarthritis

Weight loss reduces knee‐joint loads in overweight and obese older adults with knee osteoarthritis

Health consequences of obesity in the elderly: a review of four unresolved questions

Percent Body Fat More Associated with Perioperative Risks After Total Joint Arthroplasty Than Body Mass Index

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