The effects of weight loss on imaging outcomes in osteoarthritis of the hip or knee in people who are overweight or obese: a systematic review

Daugaard CL, Hangaard S, Bartels EM, Gudbergsen H, Christensen R, Bliddal H, Englund M, Conaghan PG, Boesen M · Osteoarthritis and Cartilage

The structural counterweight to the symptomatic evidence, and it is the reason this entry's tier is scoped to symptoms. Across cartilage (7 analyses), joint space width (3), bone marrow lesions (5), synovitis (2), effusion (1), meniscus (3) and infrapatellar fat pad (2): direct cartilage thickness measurements conflicted; compositional dGEMRIC and T2 mapping in early knee OA showed only trends toward less degeneration; joint space width on radiographs did not change; synovitis and effusion were unaffected. Weight loss did shrink the infrapatellar fat pad, and DXA showed bone loss at the hip. The authors conclude they found no consistent evidence of structural effects.

Population

14 articles from 6 cohorts (2 derived from RCTs), from 1,625 records screened

Intervention

Weight loss in overweight or obese people with hip or knee osteoarthritis

Comparator

No or less weight loss

Limitations

Fourteen articles from six cohorts, only two of them from randomized trials, with heterogeneous imaging outcomes — which is the authors' own headline finding: the field has not agreed on what to measure. PROSPERO CRD42017065263.