Substantial Weight Loss Associated With Reduced Cartilage Degeneration in Osteoarthritis

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The progression of focal cartilage defects was evaluated with 3 Tesla whole-organ magnetic resonance imaging score.
The progression of focal cartilage defects was evaluated with 3 Tesla whole-organ magnetic resonance imaging score.

Patients with osteoarthritis (OA) who achieved a >10% weight loss were found to have reduced cartilage degeneration compared with patients achieving only moderate or no weight loss, according to a study presented at the Radiological Society of North America's 2017 annual meeting held November 26 to December 1 in Chicago, Illinois.

For this study, a total of 290 overweight patients in the Osteoarthritis Initiative (mean age, 61.7±9.1; 58.9% women; body mass index [BMI] >25kg/m2), with mild to moderate OA or with risk factors for OA were included in this analysis. Patients with ≥10% (n=36) and with 5% to 10% (n=109) weight loss were considered to have achieved large and moderate weight loss, respectively. A stable-weight group included 145 patients with a BMI change <3%.

The progression of focal cartilage defects — evaluated with 3 Tesla whole-organ magnetic resonance imaging (MRI) score — was reduced in patients in both weight loss groups, compared with patients who maintained a stable weight (>10% weight loss, P <.0001; 5%-10% weight loss, P =.035;) over a 48-month period.

Compared with the stable-weight group, study participants with large vs no weight loss had reduced T2 value increase for 5 compartments of the knee (P <.01). The cartilage degeneration in the medial compartment of the knee was reduced in participants with large vs no weight loss, as indicated by the overall T2 and whole-organ MRI (P <.0001 for both), and the homogeneity in this compartment was increased in the >10% vs no weight loss group (P =.004). A correlation analysis indicated an association between weight loss and progression of cartilage degeneration (correlation factor, r=.31; P <.02).

“MRI-based knee cartilage T2 measurements and semiquantitative grading allow monitoring of the protective effect of weight loss on joint health and are useful to determine which amount of weight loss is most beneficial in overweight and obese patients,” noted the investigators. “Our data show evidence that weight loss has a protective effect against cartilage degeneration and that a larger amount of weight loss is more beneficial,” they concluded.

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Reference

Gersing A, Solka M, Joseph G, et al. Weight loss is associated with slower cartilage degeneration over 48 months in obese and overweight subjects: data from the osteoarthritis initiative. Presented at: RSNA 2017; November 26-December 1, 2017; Chicago, IL. Abstract SSC07-03. 

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