Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients

ARTICLE:

Christensen R, Henriksen M, Leeds AR, et al. Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: a twelve-month randomized controlled trial. Arthritis Care Res (Hoboken). 2015 May;67(5):640-50. doi: 10.1002/acr.22504. (Original) PMID: 25370359

ABSTRACT

OBJECTIVE: To 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).
METHODS: We 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.
RESULTS: Mean 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).
CONCLUSION: A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program.// <![CDATA[

function OpenWindow(strURL, strWindowName, intWidth, intHeight) {
var strFeatures = ‘width=’ + intWidth +
‘,height=’ + intHeight +
‘,directories=’ + 0 +
‘,location=’ + 0 +
‘,menubar=’ + 0 +
‘,scrollbars=’ + 1 +
‘,status=’ + 0 +
‘,toolbar=’ + 0 +
‘,resizable=’ + 1;
window.open(strURL, strWindowName, strFeatures);
}

function OpenWindowNormal(strURL, strWindowName, intWidth, intHeight) {
var strFeatures = ‘width=’ + intWidth +
‘,height=’ + intHeight +
‘,directories=’ + 1 +
‘,location=’ + 1 +
‘,menubar=’ + 1 +
‘,scrollbars=’ + 1 +
‘,status=’ + 1 +
‘,toolbar=’ + 1 +
‘,resizable=’ + 1;
window.open(strURL, strWindowName, strFeatures);
}

function ResetSmartScroll() {
if (typeof (theForm.elements[‘__SCROLLPOSITIONX’].value) != “undefined”) { theForm.elements[‘__SCROLLPOSITIONX’].value = 0; }
if (typeof (theForm.elements[‘__SCROLLPOSITIONY’].value) != “undefined”) { theForm.elements[‘__SCROLLPOSITIONY’].value = 0; }

if (typeof (theForm.__SCROLLPOSITIONX.value) != “undefined”) { theForm.__SCROLLPOSITIONX.value = 0; }
if (typeof (theForm.__SCROLLPOSITIONY.value) != “undefined”) { theForm.__SCROLLPOSITIONY.value = 0; }

if ((typeof (theForm.submit) != “undefined”) && (typeof (theForm.oldSubmit) != “undefined”)) { theForm.submit = theForm.oldSubmit; } else { theForm.submit = null; }
if ((typeof (theForm.onsubmit) != “undefined”) && (typeof (theForm.oldOnSubmit) != “undefined”)) { theForm.onsubmit = theForm.oldOnSubmit; } else { theForm.onsubmit = null; }

scrollTo(0, 0);
}

function toggleLI(theLI) {
if (document.getElementById(theLI).style.display == ‘none’) {
document.getElementById(theLI).style.display = ‘block’;
} else {
document.getElementById(theLI).style.display = ‘none’;
}
}

// ]]>// <![CDATA[

try {
document.execCommand(“BackgroundImageCache“, false, true);
} catch (err) {
}

// ]]>

Comments from Clinical Raters
General Internal Medicine-Primary Care(US  I don’t think this article meaningfully informs the conversation about weight and knee OA pain and function.
RheumatoloGY  This randomized trial showed that symptomatic improvement in knee osteoarthritis is achieved by weight loss in obese patients. In the one year following intensive weight loss, improvement is sustained regardless of whether diet control, knee exercises or no intervention is carried out. This underscores the importance of weight loss for obese patients with OA of the knees.
Special Interest – Obesity — Physician  Well designed research supporting need for major weight loss through diet combined with exercise to decrease knee pain in obese patients. Although not really new information, the study does a nice job of making clear this is the way to go.
Special Interest – Obesity — Physician  An interesting study to read and review, partly due to the surprising results in the control group. The reduction in VAS pain was modest, but statistically significant. The weight loss group was expensive at 1170 Euros.
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s