The Effects of Bariatric Surgery Weight Loss on Knee Pain in Patients with Osteoarthritis of the Knee

Abstract

Studies have shown that osteoarthritis (OA) is highly associated with obesity, and individuals clinically defined as obese (BMI > 30.0 kg/m2) are four times more likely to have knee OA over the general population. The purpose of this research was to examine if isolated weight loss improved knee symptoms in patients with osteoarthritis. Adult patients (n = 24; age 18–70; BMI > 35 kg/m2) with clinical and radiographic evidence of knee OA participated in a one-year trial in which WOMAC and KOOS surveys were administered at a presurgery baseline and six and twelve months postsurgery. Statistical analysis was performed using Student's t and Wilcoxon Signed Rank tests. Weight loss six and twelve months following bariatric surgery was statistically significant (P < 0.05) compared to presurgery measurements. All variables from both KOOS and WOMAC assessments were significantly improved (P < 0.05) when compared to baseline. Isolated weight loss occurring via bariatric surgery resulted in statistically significant improvement in patient's knee arthritis symptoms at both six and twelve months. Further research will need to be done to determine if symptom relief continues over time, and if the benefits are also applicable to individuals with symptomatic knee arthritis that are overweight but not obese.

Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity

“…The findings from this study reinforce shorter-term results from studies that have reported significant improvements in SF-36 bodily pain and physical function scores, 29–32 WOMAC scores, 29,33,34 walking capacity (as measured by the LDCW or the 6-minute walk test), 30,31,35,36 resting heart rate, 35,36 or other measures of pain and function 10–12 in the first 3 to 12 months following RYGB or LAGB. Few studies have reported on pain and function from longer-term follow-up of these procedures.…”

Influence of morbid obesity on physical capacity, knee-related symptoms and overall quality of life: A cross-sectional study

“…27 Obesity is related with these changes by means of two interconnected pathways: increased load caused by excessive weight, and systemic effects related with chronic inflammation linked to imbalance in the release of active peptides produced by the fat tissue known as adipocytokines. 22,28,29 The assessment of knee-related symptoms using KOOS score in this study has shown impact mainly regarding pain and other symptoms compared with the mean values in non-obese individuals as reported in a systematic review by Collins et al 30 In a prospective study, Edwards et al 31 observed significant improvement in the five domains of KOOS following weight loss, while Gudbergsen et al 32 reported improvement in pain and function in daily living domains after weight loss. Thus, the results observed in our study regarding the KOOS methodology were similar to those previously observed in the literature.…”

Effects of bariatric surgery for knee complaints in (morbidly) obese adult patients: a systematic review

“…The intensity of knee pain was not correlated with the amount of weight loss in one study . Improvement of WOMAC and KOOS scores were positively correlated with amount of weight loss in one study (not significant) . Recovery rates for work‐restricting knee pain was found significantly related with amount of weight loss in one study .…”

“…Ten out of 13 studies (77%) reported a significant improvement in at least one of these assessments. When taken all the different assessments together, 14 out of the 19 different assessments (73%) found a significant improvement .…”