"Weight
Loss as Treatment for Knee Osteoarthritis Symptoms in Obese
Patients"
Information sourced from BMJ
Clinical and epidemiological research
Extended report:
Weight loss as treatment for knee osteoarthritis symptoms
in obese patients: 1-year results from a randomised controlled
trial
Bliddal H, Leeds AR, Stigsgaard L, Astrup A, Christensen
R
Correspondence to: Professor J Bliddal, The Parker Institute,
Copenhagen University Hospital, Frederiksberg, DK-2000F,
Denmark; henning.bliddal@frh.regionh.dk
Abstract
Objective: To evaluate 1-year symptomatic
improvement in obese patients with knee osteoarthritis
(OA) on an intensive
low-energy diet (LED) maintained by frequent consultations
with a dietician compared to minimal attention.
Methods: The LED programme consisted
of group therapy with dietary consultations and two periods
of a low-calorie
diet of 810 kcal/day during weeks 0–8 and weeks 32–36.
The control group only received dietary instruction and
attention for 2 h at baseline, and at weeks 8, 32, 36 and
52. The primary end point (total Western Ontario and McMaster
Universities (WOMAC) index) was assessed as the mean group
difference during and after 1 year.
Results: The study population consisted
of 89 patients, 89% women, average age 63 years. After
1 year, mean weight
loss in the LED group was -10.9 kg (11%) versus -3.6 kg
(4%) in the control group (p<0.0001). There was no difference
between the groups in total WOMAC index (p=0.11), although
both groups improved. However, the LED intervention resulted
in less WOMAC pain (7.7 mm), with a group mean difference
of 7.2 mm (95% CI 1.0 to 13.4, p=0.022). After one year
14 (32.8%) responded to LED versus 7 (15.6%) to control,
with an absolute benefit of 16.3% (-1.1& to 33.6%,
p=0.066).
Conclusion Continuous reinforcement of a weight loss programme
can be successful over a year in obese knee OA patients.
Weight loss was statistically reflected only by a reduction
in pain. However, the overall clinical benefits of the
intervention on health should lead to a strong recommendation
of weight loss in this group of patients
Copyright © 2011 BMJ Publishing Group Ltd & European
League Against Rheumatism. All rights reserved.
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