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.


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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

Additional weight loss was significantly associated with a smaller increase in WORMS cartilage score (β = 0.2; 95% CI, 0.02-0.4; P =.007), with 1% weight loss representing a 0.2% lower increase in WORMS cartilage score over the study period.

“Our findings suggest that weight loss may have a protective effect on knee cartilage and menisci and that greater weight loss may be even more beneficial for knee joint health in obese and overweight individuals,” the investigators concluded.

Limitations & Disclosures

Additional weight loss was significantly associated with a smaller increase in WORMS cartilage score (β = 0.2; 95% CI, 0.02-0.4; P =.007), with 1% weight loss representing a 0.2% lower increase in WORMS cartilage score over the study period.

“Our findings suggest that weight loss may have a protective effect on knee cartilage and menisci and that greater weight loss may be even more beneficial for knee joint health in obese and overweight individuals,” the investigators concluded.

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Reference

Gersing AS, Schwaiger BJ, Nevitt MC, et al. Is weight loss associated with less progression of changes in knee articular cartilage among obese and overweight patients as assessed with MR imaging over 48 months? Data from the Osteoarthritis Initiative [published online May 2, 2017]. Radiology. doi:10.1148/radiol.2017161005