Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial

Henriksen, Marius; Hunter, David J.; Dam, Erik B.; Messier, Stephen P.; Andriacchi, Thomas P.; Lohmander, L. Stefan; Aaboe, J.; Boesen, Mikael; Gudbergsen, Henrik; Bliddal, Henning; Christensen, R.

doi:10.1016/j.joca.2013.10.003

Cited by 18 publications

(9 citation statements)

References 55 publications

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“…They found that only at least 10 % change in bodyweight significantly influences the risk of cOA progression. Henriksen et al found no association for change in peak knee joint compressive forces and cOA progression [ 18 ]. A decrease in peak knee force (or unloader) was defined as decrease in body mass, unchanged walking speed, and a decreased knee extensor moment.…”

Section: Resultsmentioning

confidence: 99%

Prognostic factors for progression of clinical osteoarthritis of the knee: a systematic review of observational studies

Bastick¹,

Runhaar²,

Belo³

et al. 2015

Arthritis Res Ther

137

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IntroductionWe performed a systematic review of prognostic factors for the progression of symptomatic knee osteoarthritis (OA), defined as increase in pain, decline in physical function or total joint replacement.MethodWe searched for available observational studies up to January 2015 in Medline and Embase according to a specified search strategy. Studies that fulfilled our initial inclusion criteria were assessed for methodological quality. Data were extracted and the results were pooled, or if necessary summarized according to a best evidence synthesis.ResultsOf 1,392 articles identified, 30 met the inclusion criteria and 38 determinants were investigated. Pooling was not possible due to large heterogeneity between studies. The best evidence synthesis showed strong evidence that age, ethnicity, body mass index, co-morbidity count, magnetic resonance imaging (MRI)-detected infrapatellar synovitis, joint effusion and baseline OA severity (both radiographic and clinical) are associated with clinical knee OA progression. There was moderate evidence showing that education level, vitality, pain-coping subscale resting, MRI-detected medial femorotibial cartilage loss and general bone marrow lesions are associated with clinical knee OA progression. However, evidence for the majority of determinants was limited (including knee range of motion or markers) or conflicting (including age, gender and joint line tenderness).ConclusionStrong evidence was found for multiple prognostic factors for progression of clinical knee OA. A large variety in definitions of clinical knee OA (progression) remains, which makes it impossible to summarize the evidence through meta-analyses. More research on prognostic factors for knee OA is needed using symptom progression as an outcome measure. Remarkably, only few studies have been performed using pain progression as an outcome measure. The pathophysiology of radiographic factors and their relation with symptoms should be further explored.

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Section: Resultsmentioning

confidence: 99%

Prognostic factors for progression of clinical osteoarthritis of the knee: a systematic review of observational studies

Bastick¹,

Runhaar²,

Belo³

et al. 2015

Arthritis Res Ther

137

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“…This low‐energy, formula‐diet, weight‐loss programme was shown to reduce OA symptoms , although no changes were demonstrated in bone marrow lesions in response to weight loss . The impact of increased knee joint loading because of improved ambulatory function and walking speed following weight loss was also investigated; no acceleration of symptomatic and structural disease progression was observed in patients with increased joint loads relative to those with reduced joint loads .…”

Section: Evidencementioning

confidence: 99%

Osteoarthritis, obesity and weight loss: evidence, hypotheses and horizons – a scoping review

2014

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Obesity is widely acknowledged as a risk factor for both the incidence and progression of osteoarthritis, and has a negative influence on outcomes. Loss of at least 10& of body weight, coupled with exercise, is recognized as a cornerstone in the management of obese patients with osteoarthritis, and can lead to significant improvement in symptoms, pain relief, physical function and health-related quality of life. However, questions still remain surrounding optimal management. Given the significant health, social and economic burden of osteoarthritis, especially in obese patients, it is imperative to advance our knowledge of osteoarthritis and obesity, and apply this to improving care and outcomes. This paper overviews what is already known about osteoarthritis and obesity, discusses current key challenges and ongoing hypotheses arising from research in these areas, and finally, postulates what the future may hold in terms of new horizons for obese patients with osteoarthritis.

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“…Premature degeneration of articular cartilage is known to occur simultaneous to abnormal joint biomechanics in multiple aberrant health conditions including PFP, 89 ACLR, [90][91][92][93] and obesity. [94][95][96] Joint degeneration is associated with biomechanics reflecting joint overloading and underloading for ACLR and obesity. [90][91][92][94][95][96] The idea that abnormal loads contribute to premature articular cartilage degradation is a difficult idea to test using human subjects and will likely require future longitudinal research.…”

Section: Knee Pain and Chronic Joint Healthmentioning

confidence: 99%

“…[94][95][96] Joint degeneration is associated with biomechanics reflecting joint overloading and underloading for ACLR and obesity. [90][91][92][94][95][96] The idea that abnormal loads contribute to premature articular cartilage degradation is a difficult idea to test using human subjects and will likely require future longitudinal research. Such longitudinal data will be essential to understanding ramifications of joint pain.…”

Section: Knee Pain and Chronic Joint Healthmentioning

confidence: 99%

A Review of the Relationships Between Knee Pain and Movement Neuromechanics

Seeley¹,

Lee²,

Son³

et al. 2022

Journal of Sport Rehabilitation

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Context: Knee injury and disease are common, debilitating, and expensive. Pain is a chief symptom of knee injury and disease and likely contributes to arthrogenic muscle inhibition. Joint pain alters isolated motor function, muscular strength, and movement biomechanics. Because knee pain influences biomechanics, it likely also influences long-term knee joint health. Objective: The purpose of this article is 2-fold: (1) review effects of knee pain on lower-extremity muscular activation and corresponding biomechanics and (2) consider potential implications of neuromechanical alterations associated with knee pain for long-term knee joint health. Experimental knee pain is emphasized because it has been used to mimic clinical knee pain and clarify independent effects of knee pain. Three common sources of clinical knee pain are also discussed: patellofemoral pain, anterior cruciate ligament injury and reconstruction, and knee osteoarthritis. Data Sources: The PubMed, Web of Science, and SPORTDiscus databases were searched for articles relating to the purpose of this article. Conclusion: Researchers have consistently reported that knee pain alters neuromuscular activation, often in the form of inhibition that likely occurs via voluntary and involuntary neural pathways. The effects of knee pain on quadriceps activation have been studied extensively. Knee pain decreases voluntary and involuntary quadriceps activation and strength and alters the biomechanics of various movement tasks. If allowed to persist, these neuromechanical alterations might change the response of articular cartilage to joint loads during movement and detrimentally affect long-term knee joint health. Physical rehabilitation professionals should consider neuromechanical effects of knee pain when treating knee injury and disease. Resolution of joint pain can likely help to restore normal movement neuromechanics and potentially improve long-term knee joint health and should be a top priority.

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Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial

Abstract: NCT00655941.

Cited by 18 publications

References 55 publications

Prognostic factors for progression of clinical osteoarthritis of the knee: a systematic review of observational studies

Prognostic factors for progression of clinical osteoarthritis of the knee: a systematic review of observational studies

Osteoarthritis, obesity and weight loss: evidence, hypotheses and horizons – a scoping review

A Review of the Relationships Between Knee Pain and Movement Neuromechanics

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