Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial

Christensen, Robin; Astrup, Arne; Bliddal, Henning

doi:10.1016/j.joca.2004.10.008

Cited by 299 publications

(290 citation statements)

References 57 publications

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“…37 The GBS in our study was an intervention and the WOMAC response was similar to that reported from other groups who have looked specifically at knee OA in obese populations after weight loss. 5,36 The WOMAC is a valuable tool and should be evaluated more thoroughly in the GBS population.…”

Section: Discussionmentioning

confidence: 99%

“…The most significant association is between knee osteoarthritis (OA) and obesity, 4,5 but not with OA in other weightbearing joints such as the hip or ankle. 6,7 Weight, even in the upper tertile of normal range (body mass index (BMI) 22-o25 kg/m 2 ) is associated with an increased risk of developing medial compartment and patellofemoral knee OA, 8,9 suggesting a dose response effect of weight on the incidence of knee OA.…”

Section: Introductionmentioning

confidence: 99%

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Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

et al. 2006

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Objective: To determine the point prevalence of painful musculoskeletal (MSK) conditions in obese subjects before and after weight loss following bariatric surgery. Design: Longitudinal, interventional, unblended. Subjects: Forty-eight obese subjects (47 women, one man, mean age 4479 years; mean body mass index (BMI) 5178 kg/m 2 ) recruited from an academic medical center bariatric surgery program. Measurements: Comorbid medical conditions; MSK findings; BMI; Western Ontario McMaster Osteoarthritis Index (WOMAC) for pain, stiffness and function; and SF-36 s for quality of life. Methods: Consecutive subjects were recruited from the University Hospitals of Cleveland Bariatric Surgery Program. Musculoskeletal signs and symptoms and non-MSK comorbid conditions were documented at baseline and at follow-up. Subjects completed the SF-36 s and the WOMAC questionnaires. Analyses were carried out for each MSK site, fibromyalgia syndrome (FMS) and for the cumulative effect on the spine, upper and lower extremities. The impact of change in comorbid medical conditions, BMI, physical and mental health domains of the SF-36 s on the WOMAC pain subscale score was evaluated. SF-36 s outcomes were compared to normal published controls. Results: Forty-eight subjects were available for baseline and a follow-up assessment 6-12 months after gastric bypass surgery. They lost an average of 41715 kg and the mean BMI decreased from 5178 to 3677 kg/m 2 . Baseline comorbid medical conditions were present in 96% before surgery and 23% after weight loss. There was an increased prevalence of painful MSK conditions at baseline compared to general population frequencies. Musculoskeletal complaints had been present in 100% of obese subjects before, and 23% after weight loss. The greatest improvements occurred in the cervical and lumbar spine, the foot and in FMS (decreased by 90, 83, 83 and 92%, respectively). Seventy-nine percent had upper extremity MSK conditions before and 40% after weight loss. Before surgery, 100% had lower extremity MSK conditions and only 37% did after weight loss. The WOMAC subscale and composite scores all improved significantly, as did the SF-36 s . Change in BMI was the main factor impacting the WOMAC pain score. Conclusion: There was a higher frequency of multiple MSK complaints, including non-weight-bearing sites compared to historical controls, before surgery, which decreased significantly at most sites following weight loss and physical activity. These benefits may improve further, as weight loss may continue for up to 24 months. The benefits seen with weight loss indicate that prevention and treatment of obesity can improve MSK health and function.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

et al. 2006

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“…Although the treatment group evidenced improvement in several aspects of HRQoL and maintained an average weight loss of 13.9 percent of baseline weight, improvement in bodily pain was only temporary and no longer evident at 4-month follow-up. Similarly, Christensen and colleagues demonstrated that 8 weeks on a VLED combined with weekly behavioral therapy resulted in significant improvements in both weight and pain outcomes [97]. Their findings that a modest weight loss of 10 percent resulted in a 28 percent reduction in patients' report of OA symptoms suggest that even a relatively brief dietary intervention with modest results can have a significant effect on pain symptoms.…”

Section: Lifestyle Intervention/behavioral Weight-loss Treatmentmentioning

confidence: 97%

Overview of the relationship between pain and obesity: What do we know? Where do we go next?

Janke¹,

Collins²,

Kozak³

2007

JRRD

188

141

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Abstract-Overweight/obesity and pain are significant problems of increasing prevalence; understanding the relationship between the two is the focus of a growing body of research. Findings from this review support a likely relationship between increasing weight and pain conditions such as osteoarthritis and low back pain. Longitudinal studies suggest overweight/obesity early in life is a risk factor for pain, and the co-occurrence of pain and overweight/obesity negatively affects quality of life. The mechanism of relationship is unknown but is hypothesized to include mechanical and metabolic abnormalities, possibly secondary to lifestyle choices. Observations from a few studies demonstrate that treatments for obesity reduce pain secondary to weight loss. Few studies examine both pain and weight as primary outcomes, and variability in measurement makes comparisons and conclusions difficult. Research should focus on expanding knowledge about mechanisms of the relationship between pain and obesity, testing explanatory models addressing their co-occurrence, and developing treatments that most effectively target this comorbidity.

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“…The authors found that less than four patients (95% confidence interval 2-9 patients) would need to be treated with a low-energy diet for one patient to achieve a X50% improvement in the WOMAC score (a measure of joint pain, stiffness and function) when compared to a control diet. 62 The effects of weight loss and exercise interventions on serum leptin were also assessed in the ADAPT cohort. 63 In the ADAPT cohort, serum leptin was significantly reduced by a long-term diet (weight loss) intervention with modest weight loss of 5-6%.…”

Section: Weight Reductionmentioning

confidence: 99%

The impact of obesity on the musculoskeletal system

et al. 2007

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Obesity is associated with a range of disabling musculoskeletal conditions in adults. As the prevalence of obesity increases, the societal burden of these chronic musculosketelal conditions, in terms of disability, health-related quality of life, and health-care costs, also increases. Research exploring the nature and strength of the associations between obesity and musculoskeletal conditions is accumulating, providing a better understanding of underlying mechanisms. Weight reduction is important in ameliorating some of the manifestations of musculoskeletal disease and improving function.

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Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial

Abstract: In our patients with knee OA, a weight reduction of 10% improved function by 28%. LED might be of advantage to control diet because of the rapidity of weight loss and a more significant loss of body fat.

Cited by 299 publications

References 57 publications

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

Overview of the relationship between pain and obesity: What do we know? Where do we go next?

The impact of obesity on the musculoskeletal system

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