Obesity-related juvenile form of cartilage lesions: a new affliction in the knees of morbidly obese children and adolescents

Widhalm, Harald; Marlovits, Stefan; Welsch, Goetz H.; Dirisamer, Albert; Neuhold, A; Griensven, Martijn van; Seemann, Rudolf; Vécsei, V.; Widhalm, Kurt

doi:10.1007/s00330-011-2281-5

Cited by 23 publications

(18 citation statements)

References 44 publications

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“…[10,11] This is also seen in the paediatric population where Widhalm and colleagues demonstrated abnormalities in the knee articular cartilage in a population of 20 morbidly obese children and adolescents. [12] Our results support the findings of these studies in demonstrating a strong positive correlation between subcutaneous knee fat thickness, as a surrogate marker of obesity with the presence and severity of chondromalacia patellae on MR imaging. As chondromalacia patellae may be reversible in the early stages, it is important for early changes to be recognised, both on MR and arthroscopic evaluation, particularly in obese patients who may benefit from weight reduction programmes or bariatric intervention.…”

Section: Discussionsupporting

confidence: 90%

Correlation between Subcutaneous Knee Fat Thickness and Chondromalacia Patellae on Magnetic Resonance Imaging of the Knee

et al. 2013

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Section: Discussionsupporting

confidence: 90%

Correlation between Subcutaneous Knee Fat Thickness and Chondromalacia Patellae on Magnetic Resonance Imaging of the Knee

et al. 2013

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“…Specifically, 79% of imaged knees from morbidly obese adolescents have retropatellar lesions, 50% show lateral meniscal damage, and 87% show medial lesions. 29 Fourth, muscle strength deficits exist in obese persons with chronic pain in the low back 30,31 and in the knee. 27,28 Inadequate strength may perpetuate poor biomechanics and joint malalignment.…”

Section: Musculoskeletal Pain In Obesitymentioning

confidence: 99%

Musculoskeletal Pain, Fear Avoidance Behaviors, and Functional Decline in Obesity

Vincent

Adams

Vincent

et al. 2013

Regional Anesthesia and Pain Medicine

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Individuals with musculoskeletal pain exhibit abnormal movement patterns, including antalgic gait, postural dysfunction, increased thoracolumbar stiffness, decreased proprioception, and altered activation of abdominal and extensor muscles. Additionally, aberrant or increased biomechanical forces over time produce joint or structural damage that results in pain. A large body habitus resulting from excessive weight can accelerate these musculoskeletal complaints. Irrespective of age, obesity contributes to chronic musculoskeletal pain, impairment of mobility, and eventual physical disability. Potential mechanisms that may mediate the relationships between obesity-related pain and functional decline include skeletal muscle strength deterioration, systemic inflammation, and psychosocial characteristics (eg, pain catastrophizing, kinesiophobia, and depression). Treatment considerations for obese patients with musculoskeletal pain include assessment of kinesiophobia levels, biomechanical analysis, and pain medication use. Ideally, a multidisciplinary team of physicians, psychologists, and physical therapists should optimize the design of interventions specific to the patient. In some cases, the use of appropriate pain medications or intra-articular injectable agents may help control pain, fostering sustained activity, caloric expenditure, and weight loss. Morbid obesity is a medical condition that alters biomechanical forces on the tissues of the body. This condition provides the opportunity to examine accelerated development of musculoskeletal pain syndromes and etiology. The proposed therapeutic interventions can have multiple benefits in the obese population including weight loss, improved psychological outlook and self-efficacy, reduced kinesiophobia levels, reduced risk of functional dependence, and improved quality of life.

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“…When overweight begins in childhood, the risk of early (<50 years) knee and hip OA is much higher compared with that in the normal weight population. 10 11 12 …”

Section: Introductionmentioning

confidence: 99%

Early Efficacy of Intra-Articular HYADD® 4 (Hymovis®) Injections for Symptomatic Knee Osteoarthritis

Priano¹

2017

Joints

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Purpose The aim of the study was to evaluate the clinical effects of HYADD® 4, an hydrogel based on a hyaluronic acid derivative, in patients with symptomatic knee osteoarthritis, on symptoms, and joint function. Methods This retrospective study of patients with Kellgren–Lawrence grade II to IV knee osteoarthritis (American College of Rheumatology criteria) enrolled patients who had received two infiltrations of HYADD® 4, (24 mg/3 mL) 1 week apart, and evaluated: pain at rest, pain with movement, change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score; change in nonsteroidal anti-inflammatory drugs (NSAIDs)/acetaminophen use; satisfaction with therapy; tolerability. Study duration was 6 months for all predefined endpoints, with a 6-month extension for pain symptoms only. Results After 6 months, all predefined endpoints were evaluable in 698 of 937 enrolled patients (74.5%). Mean WOMAC scores were reduced by 56.3% from baseline ( p < 0.05). NSAIDs/acetaminophen use ≥2 times/week (48.8% of patients at baseline) was substantially reduced after 1 month and was 19.6% after 6 months. After 6 months, 85.6% of patients were satisfied about efficacy. There were no significant adverse effects. The effect on resting pain was rapid, strong, and lasting: reduction from baseline was 45.1% at 1 month ( p < 0.05), 56.8% at 6 months ( p < 0.05), and 53.6% at 12 months ( p < 0.05). Pain on moving was reduced by 47.4% after 6 months ( p < 0.05) and 46.0% after 12 months ( p < 0.05), results at 6 and 12 months were similar. Conclusion HYADD® 4 is a new-generation hyaluronic acid with distinctive viscoelastic and rheological properties. In patients with mild-to-severe knee OA (Kellgren–Lawrence grades II–IV), two consecutive infiltrations 1 week apart reduced WOMAC scores and NSAIDs/acetaminophen consumption for at least 6 months. In a subpopulation ( n = 106), efficacy on pain lasted approximately 12 months. Adverse events were reported in 11.2% of patients; the most frequent were arthralgias. No cases of allergic reactions or systemic effects were recorded. Level of Evidence Level IV, retrospective case series.

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Obesity-related juvenile form of cartilage lesions: a new affliction in the knees of morbidly obese children and adolescents

Cited by 23 publications

References 44 publications

Correlation between Subcutaneous Knee Fat Thickness and Chondromalacia Patellae on Magnetic Resonance Imaging of the Knee

Correlation between Subcutaneous Knee Fat Thickness and Chondromalacia Patellae on Magnetic Resonance Imaging of the Knee

Musculoskeletal Pain, Fear Avoidance Behaviors, and Functional Decline in Obesity

Early Efficacy of Intra-Articular HYADD® 4 (Hymovis®) Injections for Symptomatic Knee Osteoarthritis

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