Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI and radiography

Gudbergsen, Henrik; Boesen, Mikael; Lohmander, L. Stefan; Christensen, R.; Henriksen, Marius; Bartels, Else Marie; Christensen, Pia; Rindel, L.; Aaboe, J.; Danneskiold‐Samsøe, Bente; Riecke, B.F.; Bliddal, Henning

doi:10.1016/j.joca.2012.02.639

Cited by 95 publications

(66 citation statements)

References 60 publications

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“…There were 23 variables investigated as possible predictors of response to the weight loss programs, including measurements of baseline hamstrings and quadriceps strength using isometric dynamometry. Baseline muscle strength was not predictive of symptomatic relief in response to the weight loss program (46). The study was underpowered to detect significant predictors from a possible 23 variables.…”

Section: Muscle Strengthmentioning

confidence: 90%

“…In contrast the two other studies categorized subjects to knee malalignment groups if the mechanical axis did not appear as a straight line (46,49). This may have increased the severity of malalignment observed within the participants assigned to the varus group investigated by Lim and colleagues, compared to the subjects categorized to knee malalignment groups in the other studies.…”

Section: Muscle Strengthmentioning

confidence: 94%

“…A knee was categorised as varus when alignment was > 0 degrees, and valgus if < 0 degrees. Baseline knee alignment was one of 23 variables examined as possible predictors, however it failed to predict improvements in Knee Injury and Osteoarthritis Outcome Scores (KOOS) or achievement of OMERACT-OARSI Responder Criterion following weight loss interventions (46). In view that only 64% of patients were treatment responders according to OMERACT-OARSI criterion, the study was underpowered to detect effects of significant predictors.…”

Section: Muscle Strengthmentioning

confidence: 99%

“…A larger RCT of 192 obese subjects with knee OA allocated patients to two different weight loss interventions (46). Knee joint alignment was assessed using a 'Plug-in Gait model' with a six camera stereophotogrammetric system and markers on anatomic landmarks.…”

Section: Muscle Strengthmentioning

confidence: 99%

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Targeting Care

Eyles

Lucas

Hunter

2013

Rheumatic Disease Clinics of North America

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Important points and objectives for recall:• Numerous studies have explored patient characteristics including: body mass index, psychological factors, muscle strength, tibiofemoral alignment, radiographic changes and signs of inflammation as potential predictors of response to non-surgical interventions for management of hip and knee OA.• Often the sample sizes utilized by these studies were inadequate to yield sufficient numbers of responders to the interventions to allow for analysis of the potential predictors identified.• A number of well-designed studies were adequately powered to provide some evidence for clinical characteristics that did or did not predict response to non-surgical interventions for participants with hip and knee OA. SynopsisInternational evidence-based guidelines recommend a multitude of non-surgical treatment options for the management of OA. In the face of so many choices, it would be helpful for clinicians to be able to base treatment decisions on the identification of specific clinical presentations that foretell greater likelihood of success following a given treatment. This review summarizes the evidence available for patient characteristics that have been analysed as potential predictors of response to non-surgical interventions for patients with hip and knee OA. The specific variables targeted for this review include: body mass index, psychological factors, muscle strength, tibiofemoral alignment, radiographic changes and signs of inflammation. Several studies provide moderate to good evidence of potential predictors of response to non-surgical treatments, while areas for future research are illuminated.

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Section: Muscle Strengthmentioning

confidence: 90%

Section: Muscle Strengthmentioning

confidence: 94%

Section: Muscle Strengthmentioning

confidence: 99%

Section: Muscle Strengthmentioning

confidence: 99%

See 2 more Smart Citations

Targeting Care

Eyles

Lucas

Hunter

2013

Rheumatic Disease Clinics of North America

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“…In trials among subjects with and without established knee OA, weight loss was shown to have advantageous structure-modifying, systemic, and clinical effects (15)(16)(17)(18)(19)(20)(21). In a systematic review on the effects of weight loss on knee OA patients, a weight loss of at least 5% of body weight was indicated for symptomatic relief (22).…”

Section: Introductionmentioning

confidence: 99%

Prevention of Incident Knee Osteoarthritis by Moderate Weight Loss in Overweight and Obese Females

Runhaar

Vos

Middelkoop

et al. 2016

Arthritis Care & Research

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Objective. This study evaluated the effect of moderate weight loss on the incidence of knee osteoarthritis (OA) in middle-aged overweight and obese women, without clinical and radiologic knee OA at baseline. Methods. A total of 353 women (87%) with followup data available were selected from the Prevention of Knee Osteoarthritis in Overweight Females study, which evaluated the preventive effect of a diet and exercise intervention and of oral glucosamine sulfate on the incidence of knee OA. This was an exploratory proof-of-concept analysis, which compared the incidence of knee OA between women who reached the clinically relevant weight loss target of 5 kg or 5% of body weight after 30 months and those who did not reach this target. Results. The weight loss group showed a significantly lower incidence of knee OA according to the primary outcome measure, which was composed of the American College of Rheumatology criteria (clinical and radiographic), Kellgren/Lawrence grade ‡2, and joint space narrowing ‡1.0 mm (15% versus 20%; odds ratio 0.5, 95% confidence interval 0.3-0.9). Moreover, the weight loss also positively affected several health measures, such as blood glucose level, body fat percentage, and blood pressure. Conclusion. A reduction of ‡5 kg or 5% of body weight over a 30-month period reduces the risk for the onset of radiographic knee OA in middle-aged overweight and obese women. Because of the slow progression of the disease, a longer followup period will be necessary before the number of prevented cases of knee OA by moderate weight loss becomes clinically more relevant.

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Effect of Weight Maintenance on Symptoms of Knee Osteoarthritis in Obese Patients: A Twelve‐Month Randomized Controlled Trial

Christensen

Henriksen

Leeds

et al. 2015

Arthritis Care & Research

113

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ObjectiveTo compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either dietary support (D), a knee-exercise program (E), or “no attention” (C; control group).MethodsWe conducted a randomized, 2-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled; the mean age was 62.5 years and 81% were women with a mean entry weight of 103.2 kg. In phase 1, all participants were randomly assigned to 1 of 3 groups and began a dietary regimen of 400–810 and 1,250 kcal/day for 16 weeks (2 8-week phases) to achieve a major weight loss. Phase 2 consisted of 52 weeks' maintenance in either group D, E, or C. Outcomes were changes from randomization in pain on a 100-mm visual analog scale, weight, and response according to the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria.ResultsMean weight loss for phase 1 was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 kg, 95% confidence interval [95% CI] 9.0, 12.8 kg) than those in the E (6.2, 95% CI 4.4, 8.1 kg) and C (8.2, 95% CI 6.4, 10.1 kg) groups (P = 0.002 by analysis of covariance [ANCOVA]). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; and C: 5.5 mm) with no difference between groups (P = 0.98 by ANCOVA). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment in the D, E, and C groups, respectively, with no statistically significant difference in the number of responders (P = 0.41).ConclusionA significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program.

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Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI and radiography

Abstract: Presence of joint damage did not preclude symptomatic relief following a clinically relevant weight loss in older obese patients with KOA. Neither muscle strength nor knee-joint alignment was associated with the degree of symptomatic relief.

Cited by 95 publications

References 60 publications

Targeting Care

Targeting Care

Prevention of Incident Knee Osteoarthritis by Moderate Weight Loss in Overweight and Obese Females

Effect of Weight Maintenance on Symptoms of Knee Osteoarthritis in Obese Patients: A Twelve‐Month Randomized Controlled Trial

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