Session Type: Abstract Submissions (ACR)
Background/Purpose: Although the strongest modifiable risk factor for the development of knee osteoarthritis (OA) is obesity, there are a paucity of data examining the effects of weight change on knee joint structures and symptoms. This study examined the effect of weight change on change in knee cartilage volume and symptoms in an obese cohort.
Methods: 112 obese subjects (BMI ≥ 30 kg m-2), unselected for any musculoskeletal disease, were recruited from various community sources to examine the effect of obesity on musculoskeletal health. Tibial cartilage volume, determined by magnetic resonance imaging, and knee symptoms, determined by the Western Ontario and McMaster Osteoarthritis Index (WOMAC), were collected at baseline and an average of 2.3 years later.
Results: Percentage weight change was associated with change in medial tibial cartilage volume (β -1.3mm3, 95% CI -2.4 to -0.1 mm3, p = 0.03) that was consistent throughout the spectrum of weight loss through to mild weight gain. Percentage weight change was not associated with change in the lateral tibial (p = 0.93) or patella (p = 0.32) cartilage volumes. Percentage weight change was associated with change in all WOMAC sub-scales (all p ≤ 0.01): pain (β -1.8mm, 95% CI -3.2 to -0.4mm), stiffness (β -1.6mm, 95% CI -2.5 to -0.7mm) and function (β -6.9mm, 95% CI -11.6 to -2.1mm).
Conclusion: The linearity of effect implies that weight loss reduces medial cartilage volume loss and improved knee symptoms, and weight gain increases medial cartilage volume loss and worsens knee symptoms. These results suggest that in obese people, even small amounts of weight change have a disease modifying effect on both knee joint structure and symptoms. While weight loss is an important primary management strategy in obese individuals, avoidance of further weight gain should also be a clinical goal.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/weight-change-has-a-disease-modifying-effect-on-knee-structure-and-symptoms-in-obese-individuals-without-diagnosed-knee-osteoarthritis/