Obesity and symptomatic osteoarthritis of the knee

• Published in: Journal of bone and joint surgery. British volume Vol. 94; no. 4; pp. 433 - 440
• Main Authors: SRIDHAR, M. S, JARRETT, C. D, XEROGEANES, J. W, LABIB, S. A
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01-04-2012
• Subjects: Arthroplasty, Replacement, Knee; Biological and medical sciences; Contraindications; Diseases of the osteoarticular system; Humans; Medical sciences; Metabolic diseases; Obesity; Obesity - complications; Obesity - therapy; Orthopedic surgery; Osteoarthritis; Osteoarthritis, Knee - etiology; Osteoarthritis, Knee - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Weight Loss; Knee; Obesity; Symptomatology; Orthopedic surgery; Knee osteoarthritis; Treatment; Diseases of the osteoarticular system; Nutrition disorder; Arthropathy; Degenerative disease; Osteoarthritis; Nutritional status
• ISSN: 0301-620X; 2044-5377
• DOI: 10.1302/0301-620X.94B4.27648

Given the growing prevalence of obesity around the world and its association with osteoarthritis of the knee, orthopaedic surgeons need to be familiar with the management of the obese patient with degenerative knee pain. The precise mechanism by which obesity leads to osteoarthritis remains unknown, but is likely to be due to a combination of mechanical, humoral and genetic factors. Weight loss has clear medical benefits for the obese patient and seems to be a logical way of relieving joint pain associated with degenerative arthritis. There are a variety of ways in which this may be done including diet and exercise, and treatment with drugs and bariatric surgery. Whether substantial weight loss can delay or even reverse the symptoms associated with osteoarthritis remains to be seen. Surgery for osteoarthritis in the obese patient can be technically more challenging and carries a risk of additional complications. Substantial weight loss before undertaking total knee replacement is advisable. More prospective studies that evaluate the effect of significant weight loss on the evolution of symptomatic osteoarthritis of the knee are needed so that orthopaedic surgeons can treat this patient group appropriately.