Knee pain is nagging, and relief is required at any cost. The aged do find it difficult to cope with the pain. Much research has been done on this health issue, and knee replacement has also been suggested.
Knee osteoarthritis (KOA) is a leading cause of pain and disability that affects the global population. Obesity is a major risk factor for KOA. Adults do tend to gain weight as they age. Knee pain can be quite troublesome.
Weight loss is usually recommended to manage knee osteoarthritis (KOA), as adults do tend to gain weight with age, which may affect KOA symptoms and progression. Efforts, or rather, studies, have been conducted to ascertain the link.
Examining the relationship between weight gain and KOA clinical features (pain, function, quality of life) and structural progression.
Results
The results do show detrimental effects of weight gain on pain stiffness, function, and the single studies, thus examining quality of life and also clinical as well as radiographic KOA. Weight gain adversely affects cartilage, bone marrow lesions, meniscal damage, and effusion/synovitis.
Weight gain in adults is indeed associated with increased clinical and structural KOA. Prevention of weight gain is important to consider to improve outcomes in KOA.
Evidence does indicate that weight loss interventions have a limited impact on reducing pain and disability. Weight loss interventions had a moderate effect on improving knee pain; a particular observation says so. Another systematic review found no significant effect of weight loss interventions in overweight or even obese individuals or weight loss compared to weight maintenance in 14 studies on reducing the progression of radiographic features like joint space narrowing on X-rays. These findings do suggest that the benefits of weight loss on the clinical and structural disease progression of KOA may indeed be modest at best and may also be marginal for small amounts of weight loss.
Secondly, achieving and sustaining significant weight loss is challenging for several individuals. As one age, weight does tend to increase, a pattern observed clearly in large prospective cohort studies. This does make long-term weight loss an uphill battle. Even if short-term weight loss is achieved, several individuals will rebound to their original weight in the long term, a phenomenon driven by genetic, hormonal, and environmental factors.
KOA can impose additional barriers like physical exercise being curtailed by KOA-induced limitations in movement. Therefore, focusing on weight loss at all costs may be an overwhelming and therefore unhelpful goal for several individuals, discouraging them from building a sense of self-efficacy and ownership of their own health. Furthermore, apart from promoting weight loss, the World Health Organization (WHO) also recommends weight maintenance and the prevention of weight gain for the management of obesity.
While the effect of weight loss has been systematically studied, the effect of weight gain has not. Given the reality of ongoing weight gain with age, it is indeed important to understand the impact of weight gain on KOA. Thus, the objectives of such a systematic review and meta-analysis are to investigate the effect of weight gain on those with (or at risk of) KOA in terms of clinical features, structural disease progression, and the likelihood of receiving a total knee replacement (TKR).
For individuals with or at risk of KOA, weight gain is associated with worsening clinical features and a greater frequency of TKR, along with a tendency for the worsening of a few features of structural disease progression. There was demographic as well as methodological variation across the included studies (largely precluding meta-analysis), with most assessing asymptomatic middle-aged individuals or even older individuals with significant KOA.
Overweight and obese patients with osteoarthritis (OA) experience more OA pain and disability than patients who are not overweight. The focus is on the long-term efficacy of combined pain coping skills training (PCST) and lifestyle behavioral weight management (BWM) interventions in overweight as well as obese OA patients.
Conclusion
Relief from knee pain is much sought after, particularly by the aged.
