Abstract
Background
The association between obesity and knee osteoarthritis, and specifically the role of obesity as a risk factor for knee osteoarthritis has been well documented. A systematic review and meta-analysis by Blagojevic et al. in Osteoarthr Cartil 18(1):24–33, (2010) examined 36 papers reporting on BMI and found that all studies demonstrated obesity and being overweight to be risk factors for knee osteoarthritis. The effect size for obesity as a risk factor for knee OA was reported to be I 2 = 97%, and the random effects pooled odds ratio for obesity compared to normal weight was 2.63 with a 95% CI of 2.28–3.05.
Objective
This review summarises recent findings involving the association between knee osteoarthritis and obesity: the potential mechanisms of the link between the two disease states; and the potential benefits of weight loss on obese, knee osteoarthritis patients.
Methods
Studies for inclusion in our report were identified using: MEDLINE; EMBASE; PUBMED; Cochrane Central Register of Controlled Trials; CINAHL; and reference lists of relevant articles.
Main results
A number of recent studies involving the association between obesity and knee osteoarthritis have since been published. A large, population-based prospective study (n = 823) conducted by Toivanen et al. with a follow-up of 22 years found that the risk for knee osteoarthritis was 7 times greater for people with BMI ≥30 compared to the control of people with BMI <25. A prospective cohort study of the Norwegian population by Grotle et al. that followed 1,675 patients reported that BMI >30 was significantly associated with osteoarthritis of the knee, with odds ratio of 2.81, and 95% CI of 1.32–5.96. Lohmander et al. found that in a large cohort study of 27,960 patients from the Swedish population, the relative risk for knee osteoarthritis (fourth quartile compared to first quartile) was 8.1, with a 95% CI of 5.3–12.4. Finally, a case–control study from Holliday et al. with 1,042 knee osteoarthritis patients and 1,121 matched controls reported that the adjusted odds ratio for knee osteoarthritis in patients with BMI >30 was 7.48 with 95% CI of 5.45–10.27.
Conclusion
Recent prospective studies demonstrate obesity as a primary risk factor for incident knee osteoarthritis. The potential mechanisms to link obesity and knee osteoarthritis, as both a biomechanical and metabolic condition are strongly linked. It has been established that weight loss for obese patients with knee osteoarthritis is clinically beneficial, for pain reduction, and for improved function. The exact mechanism linking obesity and osteoarthritis is complex; however, it is our opinion that further evidence supporting the link between the two diseases will be useful in providing clinicians and researchers with targets for physical therapy and pharmacological management of obese patients with knee osteoarthritis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
(2001) Prevalence of disabilities and associated health conditions among adults–United States, 1999. MMWR Morb Mortal Wkly Rep 50(7):120–125
Aaboe J, Bliddal H, Messier SP et al (2011) Effects of an intensive weight loss program on knee joint loading in obese adults with knee osteoarthritis. Osteoarthr Cartil 19(7):822–828
Amin S, Baker K, Niu J et al (2009) Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis. Arthritis Rheum 60(1):189–198
Blagojevic M, Jinks C, Jeffery A et al (2010) Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthr Cartil 18(1):24–33
Brosseau L, Wells GA, Tugwell P et al (2011) Ottawa panel evidence-based clinical practice guidelines for the management of osteoarthritis in adults who are obese or overweight. Phys Ther 91(6):843–861
Christensen R, Bartels EM, Astrup A et al (2007) Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis 66(4):433–439
Dillon CF, Rasch EK, Gu Q et al (2006) Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991–94. J Rheumatol 33(11):2271–2279
Dunlop DD, Song J, Semanik PA et al (2011) Objective physical activity measurement in the osteoarthritis initiative. Arthritis Rheum 63(11):3372–3382
Felson DT (2009) Developments in the clinical understanding of osteoarthritis. Arthritis Res Ther 11(1):203
Grotle M, Hagen KB, Natvig B et al (2008) Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up. BMC Musculoskelet Disord 9:132
Holliday KL, McWilliams DF, Maciewicz RA et al (2011) Lifetime body mass index, other anthropometric measures of obesity and risk of knee or hip osteoarthritis in the GOAL case–control study. Osteoarthr Cartil 19(1):37–43
Lohmander LS, d Gerhardsson V, Rollof J et al (2009) Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study. Ann Rheum Dis 68(4):490–496
Losina E, Walensky RP, Reichmann WM et al (2011) Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans. Ann Intern Med 154(4):217–226
Moyer RF, Birmingham TB, Chesworth BM et al (2010) Alignment, body mass and their interaction on dynamic knee joint load in patients with knee osteoarthritis. Osteoarthr Cartil 18(7):888–893
Niu J, Zhang YQ, Torner J et al (2009) Is obesity a risk factor for progressive radiographic knee osteoarthritis? Arthritis Rheum 61(3):329–335
Pottie P, Presle N, Terlain B et al (2006) Obesity and osteoarthritis: more complex than predicted! Ann Rheum Dis 65(11):1403–1405
Richette P, Poitou C, Garnero P et al (2011) Benefits of massive weight loss on symptoms, systemic inflammation and cartilage turnover in obese patients with knee osteoarthritis. Ann Rheum Dis 70(1):139–144
Segal NA, Zimmerman MB, Brubaker M et al (2011) Obesity and knee osteoarthritis are not associated with impaired quadriceps specific strength in adults. PM R 3(4):314–323
Sowers MR, Karvonen-Gutierrez CA (2010) The evolving role of obesity in knee osteoarthritis. Curr Opin Rheumatol 22(5):533–537
Sowers M, Karvonen-Gutierrez CA, Palmieri-Smith R et al (2009) Knee osteoarthritis in obese women with cardiometabolic clustering. Arthritis Rheum 61(10):1328–1336
Teichtahl AJ, Wang Y, Wluka AE et al (2008) Obesity and knee osteoarthritis: new insights provided by body composition studies. Obesity (Silver Spring) 16(2):232–240
Toivanen AT, Heliovaara M, Impivaara O et al (2010) Obesity, physically demanding work and traumatic knee injury are major risk factors for knee osteoarthritis—a population-based study with a follow-up of 22 years. Rheumatology (Oxford) 49(2):308–314
Zhang Y, Niu J, Felson DT et al (2010) Methodologic challenges in studying risk factors for progression of knee osteoarthritis. Arthritis Care Res (Hoboken) 62(11):1527–1532
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lee, R., Kean, W.F. Obesity and knee osteoarthritis. Inflammopharmacol 20, 53–58 (2012). https://doi.org/10.1007/s10787-011-0118-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10787-011-0118-0