Changes in the structural features of osteoarthritis in a year of weight loss. Issue 6 (June 2018)

• Record Type: Journal Article
• Authors: Jafarzadeh, S.R.; Clancy, M.; Li, J.-S.; Apovian, C.M.; Guermazi, A.; Eckstein, F.; Felson, D.T.
• Is Part Of: Osteoarthritis and cartilage. Volume 26:Issue 6(2018)
• Page Start: 775
• Page End: 782
• Publication Date: 2018-06
• Subjects: Osteoarthritis -- Weight loss -- Obesity -- Cartilage -- Magnetic resonance imaging -- Knee joint; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Arthrose -- Périodiques; Articulations -- Maladies -- Périodiques; 616.7223005
• DOI: 10.1016/j.joca.2018.03.003
• Languages: English
• ISSNs: 1063-4584

Abstract

Summary: Objective: In patients undergoing bariatric surgery or medical management for obesity, we assessed whether those experiencing substantial weight loss had changes in innervated knee structures or in cartilage. Methods: Severely obese patients (body mass index (BMI) ≥35) with knee pain on most days were seen before bariatric surgery or medical weight management and at 1-year follow-up. Examinations included 3T MRI acquired at both time points for semi-quantitative scoring of bone marrow lesions (BML), synovitis, cartilage damage, and for quantitative measurement of cartilage thickness. Association of ≥20% vs <20% weight loss with change in semi-quantitative scores was evaluated using linear mixed-effects models, and that with cartilage thickness change used non-parametric and parametric methods. Sensitivity analyses tested different thresholds for weight loss, weight loss as a continuous measure, examined those with and without bariatric surgery, and with worse osteoarthritis (OA). Results: 75 subjects (median age 49 years, 92% women) were included. At baseline, 61 subjects (81%) had Kellgren and Lawrence (KL) grade >0, and 16 (21%) had KL grade ≥3; 69 (92%) had cartilage damage. For BML, synovitis, and cartilage damage, the majority of knees had change in semi-quantitative scores of 0, and there was no difference between those with and without ≥20% weight loss. Similarly, in terms of cartilage thickness loss, in 14 of 16 sub-regions thickness loss was not associated with weight loss. Sensitivity analyses showed similar findings. Conclusion: In middle-aged persons with mostly mild radiographic OA, structural features changed little over a year and weight loss was not associated with effects on structural changes.