Weight Loss Reduces Knee Cartilage Degeneration In Patients at Risk for Osteoarthritis

Patients who were overweight and obese showed significantly lower cartilage degeneration when losing weight over 48 months, with patients who lost the most weight showing the greatest benefit, according to recent research published in the journal Radiology.

“[O]ur study showed that weight loss was significantly associated with reduced progression of knee cartilage and meniscal degeneration in obese and overweight individuals with risk factors for osteoarthritis or mild to moderate radiographic evidence of osteoarthritis,” Alexandra S. Gersing, MD, from the department of radiology and biomedical imaging at the University of California, San Francisco, and colleagues wrote.

Dr Gersing and colleagues performed a retrospective radiographic analysis of 640 patients from the Osteoarthritis Initiative who were overweight or obese and grouped them based on weight lost over 48 months: patients who lost 5% to 10% of their weight (n=238), more than 10% of their weight (n=82), or stayed the same weight (n=320). The mean age in the study was 62.9 ±9.1, and 390 patients were women. Patients were excluded from the study if they had rheumatoid arthritis, a body mass index (BMI) >25 kg/m2, or a Kellgren-Lawrence score >3 in the right knee.

Using the modified Whole-Organ Magnetic Resonance Imaging Score (WORMS), 2 radiologists reviewed right knee 3-Tesla magnetic resonance images (MRI) at baseline and 48 months for cartilage and meniscus defects. Meniscal defects under the WORMS subscale were scored from 0 points (intact) to 4 points (maceration) for the anterior, body, and posterior meniscus, while the cartilage defects were scored from 0 points to 6 points in the medial femur, lateral femur, medial tibia, lateral tibia, trochlea, and patella areas. Bone marrow edema patterns (BMEPs) were scored from 0 points to 3 points in the same areas.

The investigators found patients in the 5% to 10% weight loss group (odds ratio [OR] 1.6; 95% CI, 1.3-1.9; P =.002) and 10% weight loss group had a significantly smaller increase in WORMS cartilage score (OR 1.0; 95% CI, 0.6-1.4; P =.001) compared with patients who remained the same weight (OR 2.3; 95% CI, 2.0-2.7).

Summary & Clinical Applicability