Is Weight Loss Associated with Less Progression of Changes in Knee Articular Cartilage among Obese and Overweight Patients as Assessed with MR Imaging over 48 Months? Data from the Osteoarthritis Initiative

Gersing AS, Schwaiger BJ, Nevitt MC, et al. · Radiology

Cartilage degeneration (WORMS) progressed less with weight loss and in dose-response fashion: adjusted score change 1.0 with >10% loss and 1.6 with 5-10% loss against 2.3 with stable weight (p = .001 and p = .002). The paper's other model, the odds of any progression at all, separates only at the top of the range: >10% loss gave an odds ratio of 0.34 against stable weight (p < .001) while 5-10% gave 0.76 (95% CI 0.54 to 1.07, p = .1). Meniscal damage follows the same split (0.32, p = .004, against 0.71, p = .2). Weight change as a continuous variable does track cartilage score across everyone (β = 0.2, 95% CI 0.02 to 0.4, p = .007).

Population

Overweight/obese adults with or at risk of knee OA (Osteoarthritis Initiative), 48-month MRI follow-up

Intervention

Observed weight loss: >10% (n=82), 5-10% (n=238)

Comparator

Stable weight (n=320)

Limitations

Observational (weight loss not randomized); those who lose weight differ systematically from those who do not; semi-quantitative MRI score of the right knee only. The authors' own major limitation is that this is a retrospective read of the Osteoarthritis Initiative that never recorded how anyone lost the weight — diet, exercise or bariatric surgery — so the regimens cannot be separated. No clinical endpoint. Funded through the Osteoarthritis Initiative, with no relevant conflicts declared.