The relationship of weight loss to structure modification in knee OA.

The global obesity epidemic continues apace and thus far efforts to reverse this are failing. The osteoarthritis (OA) community should be concerned as this is the leading modifiable risk factor for disease. Greater body mass index and obesity are associated with a heightened risk of hip and knee OA1 with the obesity attributable risk for OA-indicated knee joint replacement an astounding 31%2.

This has important implications both from a prevention and disease management perspective. From a prevention perspective thus far there is only one post hoc analysis of a clinical trial, demonstrating that a 5% weight loss resulted in a threefold reduction in incident clinical knee OA after 6 years (21% vs 7%), and a 2.5-fold reduction in radiographic knee OA development (16% vs 6%)3. An important research priority over the next few years is to establish the prevention benefits of weight loss in persons at high risk for OA...