Obese Knee Osteoarthritis Patients Research Articles

Metformin as adjuvant therapy in obese knee osteoarthritis patients

AimsThis study aimed at investigating the efficacy of metformin as adjuvant therapy for obese knee osteoarthritis (OA) patients, considering its anti-inflammatory and cartilage-protective effects.Patients and methodsIn this randomized, double-blind, placebo-controlled study, 50 obese knee OA patients were assigned randomly to two groups, the metformin group (n = 25) which was treated with metformin 500 mg orally BID plus celecoxib 200 mg orally once daily, and the placebo group (n = 25) which was treated with placebo tablets BID plus celecoxib 200 mg orally once daily for 12 weeks. Cartilage Oligomeric Matrix Protein (COMP), C-terminal cross-linked telopeptide of type I collagen (CTX-1), and Interleukin 1-beta (IL-1β) serum levels were measured, while Western Ontario and McMaster Universities Arthritis Index (WOMAC) score assessed knee pain, stiffness, and physical function at baseline and after 12 weeks.ResultsFollowing a 12-week treatment, the metformin group exhibited significantly reduced levels of COMP, CTX-1, and IL-1β in the serum compared to the placebo group (p = 0.0081, p = 0.0106, and p = 0.0223, respectively). Furthermore, metformin group produced significant improvements in WOMAC total scale (p < 0.0001), specifically in knee pain, stiffness, and physical function compared to placebo group (p < 0.0001, p < 0.0001, and p < 0.0001, respectively).ConclusionMetformin as an adjuvant therapy in obese knee OA patients may have beneficial effects on cartilage degradation and inflammation, as evidenced by the significant decreases in serum COMP, CTX-1, and IL-1β levels. Additionally, metformin may improve clinical outcomes, as shown by the significant improvements in WOMAC scores.Clinicaltrials.gov IDNCT05638893/Registered December 6, 2022 — Retrospectively.

The Efficacy of Platelet-Rich Plasma Injection Therapy in Obese versus Non-Obese Patients with Knee Osteoarthritis: A Comparative Study.

Background/Objectives: Obesity is a common comorbidity in knee osteoarthritis (KOA) patients. Platelet-Rich Plasma (PRP) injection therapy may mitigate KOA. To further clarify potential patient selection for PRP injection therapy, we compared the outcomes in patients with different body mass index (BMI). Methods: A total of 91 patients with mild to moderate KOA were treated with three intra-articular PRP injections at 10 to 14-day intervals. Range of motion (ROM), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS) were documented before and after the injections at 15 days, 6 months, 12 months, and at the last follow-up. Outcomes were compared between patients with a BMI over 30 kg/m2 (obese, n = 34) and under 30 kg/m2 (non-obese, n = 57). Results: Significant difference during the follow-up was detected in WOMAC score at the last follow-up favouring BMI under 30 group [17.8 ± 18.8 versus 10.5 ± 11.7, p = 0.023]. The odds ratio (OR) in BMI over 30 kg/m2 group for total knee arthroplasty was 3.5 (95% CI 0.3-40.1, p = 0.553), and OR for any arthroplasty was 7.5 (95% CI 0.8-69.8, p = 0.085) compared to non-obese patients. Conclusions: Obese patients benefitted from PRP injections in KOA but there is a minimal difference favouring non-obese patients in symptom alleviation in follow-up stages after 12 months. The risk of arthroplasty is higher for obese KOA patients.

The Role of Rehabilitation Exercises on Weight, Functional Strength, and Exercise Adherence in Knee Osteoarthritis Patients.

Knee osteoarthritis (OA) is a weight-bearing joint disease and is more common in overweight and obese persons. The objective of this study was to determine the role of rehabilitation exercises (REs) of lower limbs on weight, functional strength, and exercise adherence in overweight and obese knee OA patients. The patients were recruited from the urban community of Lahore, Pakistan. The patients were divided into the rehabilitation group (RG) and control group (CG). The patients in the RG performed the REs of lower limbs and followed the instructions of daily care (IDC), while the patients in the CG only followed the IDC for a 12 weeks period. Outcome measures were assessed at pre-test before grouping and post-test after 12-weeks of interventions. The measures included: weight, functional strength, and exercise adherence. The Paired Samples t-test (for normally distributed data) and the Wilcoxon Signed Ranked Test (for data that was not normally distributed) were used to analyze the differences within groups from pre to post-test measurements. The variance 2 × 2 factors and the Mann Whitney U-test were used to analyze the difference in weight and functional strength between the groups. The patients in the RG reported a statistically significant weight reduction (p < 0.001) and improvement in the functional strength (p < 0.001) within a group. Similarly, the patients in the CG also reported a significant improvement in the scores of functional strength (p = 0.004) within a group. The improvement in the scores of functional strength was higher in the patients of RG than the CG (p < 0.001). Similarly, the patients in the RG reported a statistically significant reduction in weight than the CG (p < 0.001). The REs could improve weight, functional strength and exercise adherence.

Increase in CD5L expression in the synovial membrane of knee osteoarthritis patients with obesity.

IntroductionObesity appears to be a powerful risk factor for the development of knee osteoarthritis (KOA), but the mechanisms of this are not fully understood. CD5L is expressed in tissue macrophages and is increased in obese mice. We hypothesized that CD5L expression is increased in the synovial membrane (SM) of obese KOA patients. Here, we investigated CD5L expression in the SM of these patients.Material and methodsNinety KOA patients (26 males, 64 females) were allocated to one of three groups based on body mass index (BMI): normal weight (NW, < 25 kg/m²), overweight (OW, 25-29.99 kg/m²) and obese (OB, ≥ 30 kg/m²), according to the World Health Organization BMI classification (each n = 30). Expression of CD5L in SM among the groups was compared using real-time polymerase chain reaction. To investigate CD5L-expressing cells in SM, CD14+ (macrophage fraction) and CD14– (fibroblast fraction) cells were separated from the SM.ResultsCD5L expression was significantly higher in the OB group than in the NW and OW groups (p < 0.001). CD5L expression was observed in the CD14+ fraction but not in the CD14– fraction.ConclusionsCD5L is highly expressed in the SM of KOA patients with obesity. Further investigation is required to identify the role of CD5L in the relationship between KOA pathology and obesity.

Osteoarthritis Knee Patient with Obesity in Airlangga University Hospital Surabaya

Osteoarthritis is a degenerative disorder, which is characterized by the occurrence of thinning of the cartilage in the joints and causes bones to rub against each other so that stiffness, pain, and movement disorders arise. The condition of obesity can worsen osteoarthritis and cause complications of knee deformity. Objection of this study was to knowing the profile of knee osteoarthritis patients with obesity in the physical medicine and rehabilitation department of Airlangga University Hospital Surabaya. This research is a retrospective descriptive study by taking data from secondary data in the form of medical records for osteoarthritis patients in 2017 at the physical medicine and rehabilitation department of Airlangga University Hospital Surabaya. The results obtained was from a total sample of 36 obese knee osteoarthritis patients, the highest age group was 50-69 years (66,7%), dominated by female (69,4%), patients was grade 1 obese (77,8%), patients had bilateral knee osteoarthritis (47,2%), and the highest severity of osteoarthritis was grade 2 (61,1%). Then obtained osteoarthritis patients with obesity accompanied by knee deformity amounted to 9 people, with the most common deformity was varus deformity (81,25%) from total patients with deformity. Knee osteoarthritis was mostly found in elderly and female. Most patients were grade 1 obesity. More patients with bilateral osteoarthritis with grade 2-3. The knee deformity that more commonly found in patients was varus deformity.

Rehabilitation protocol with or without mobile health in overweight and obese knee osteoarthritis patients - a pilot study

Knee osteoarthritis (OA) is a degenerative and weight bearing joint disease that resulted from wear and tear of articular cartilage. It is more common in the overweight and obese knee OA patients. The objectives of pilot study were to assess the feasibility, acceptability and challenges of study design, study setting and tools of lower limb rehabilitation protocol among the knee OA patients who are overweight and obese. Twelve overweight and obese knee OA patients attending a Teaching Bay in the Pakistan were enrolled in the study and completed 6 training sessions over 2 weeks. The participants were divided randomly into Intervention Group with Mobile Health (IGW-mH), Intervention Group without Mobile Health (IGWO-mH) and the Control Group (CG). Both intervention groups were provided fifteen days of lower limb rehabilitation protocol but the CG did not. Two text messages per day for three days a week were sent to IGW-mH as a reminder to carry on their training session and instructions of daily care. All participants of intervention groups showed willingness to randomization and adherence to training sessions. The results indicated that eligibility criteria, recruitment rate and randomization procedures were feasible and there were no adverse events from training sessions. The participants demanded Urdu translation and pictures of lower limb rehabilitation protocol. Key words: mobile health technology, overweight, knee, osteoarthritis,

Knee adduction moments are not increased in obese knee osteoarthritis patients during stair negotiation

BackgroundNegotiating stairs is an important activity of daily living that is also associated with large loads on the knee joint. In medial compartment knee osteoarthritis, the knee adduction moment during level walking is considered a marker for disease severity. It could be argued that the discriminative capability of this parameter is even better if tested in a strenuous stair negotiation task. Research questionWhat is the relation with knee osteoarthritis on the knee adduction moment during the stance phase of both stair ascent and descent in patients with and without obesity? MethodsThis case control study included 22 lean controls, 16 lean knee osteoarthritis patients, and 14 obese knee osteoarthritis patients. All subjects ascended and descended a two-step staircase at a self-selected, comfortable speed. Three-dimensional motion analysis was performed to evaluate the knee adduction moment during stair negotiation. ResultsObese knee osteoarthritis patients show a prolonged stance time together with a more flattened knee adduction moment curve during stair ascent. Normalized knee adduction moment impulse, as well as the first and second peaks were not different between groups. During stair descent, a similar increase in stance time was found for both osteoarthritis groups. SignificanceThe absence of a significant effect of groups on the normalized knee adduction moment during stair negotiation may be explained by a lower ambulatory speed in the obese knee osteoarthritis group, that effectively lowers vertical ground reaction force. Decreasing ambulatory speed may be an effective strategy to lower knee adduction moment during stair negotiation.

Increase in mast cell marker expression in the synovium of obese patients with osteoarthritis of the knee.

Purpose: While research suggests that obesity is a risk factor for knee osteoarthritis (KOA), the mechanisms are not fully understood. Mast cell (MC) numbers are increased in the osteoarthritic synovium and in the adipose tissue of obese individuals. We hypothesized that MC numbers are increased in the synovium of obese KOA patients. This study investigated MC marker and MC-generated cytokine/growth factor expression in the synovium of obese KOA patients.Patients and methods: Patients radiographically diagnosed with KOA (male: 38, female: 132) were allocated to three groups based on their body mass index (BMI): normal (<25 kg/m2), overweight (25–29.99 kg/m2) and obese (≥30 kg/m2), according to the World Health Organization BMI classification. We used real-time polymerase chain reaction to compare the expression of MC markers (CD117, CD203c) and growth factors/cytokines (FGF2, VEGFA, TNFA, and IL8) in patients’ synovium among the groups.Results: CD117 expression was significantly higher in the obese group than in the normal and overweight groups. CD203c and FGF2 expression were higher in the obese group than in the normal group. FGF2 expression levels were significantly correlated with those of CD117 (ρ=0.487) and CD203c (ρ=0.751).Conclusion: MC markers CD117 and CD203c, and FGF2 were highly expressed in the synovium of obese KOA patients. Further investigations are needed to reveal the role of MCs in the relationship between obesity and osteoarthritis pathology.

Tranexamic acid reduces intraoperative occult blood loss and tourniquet time in obese knee osteoarthritis patients undergoing total knee arthroplasty: a prospective cohort study.

PurposeObesity can result in increased blood loss, which is correlated with poor prognosis in total knee arthroplasty (TKA). Clinical application of tranexamic acid is effective in reducing blood loss in TKA. However, most previous studies focused on the effect of tranexamic acid in the whole population, neglecting patients with specific health conditions, such as obesity. We hypothesized that tranexamic acid would reduce blood loss to a greater extent in obese patients than in those of normal weight.Patients and methodsA total of 304 patients with knee osteoarthritis treated with TKA from October 2013 to March 2015 were separated into tranexamic, non-tranexamic, obese, and non-obese groups. The demographic characteristics, surgical indices, and hematological indices were all recorded. We first investigated the ability of intravenous tranexamic acid to reduce intraoperative blood loss in knee osteoarthritis patients undergoing unilateral TKA. Second, we performed subgroup analysis to compare the effects of tranexamic acid between obese and non-obese patients separately.ResultsOf the 304 patients, 146 (52.0%) received tranexamic acid and 130 (42.8%) were obese. In the analysis of the whole group, both the actual and occult blood loss volume were lower in the tranexamic acid group (both P < 0.05). Tourniquet time was shorter in the tranexamic acid group (P < 0.05). In subgroup analysis, tranexamic acid was shown to reduce theoretical and actual blood loss in both the obese and non-obese groups (P < 0.05). Tranexamic acid reduced occult blood loss and tourniquet time in the obese group (P < 0.05), while no such effects were observed in the non-obese group (P > 0.05).ConclusionTranexamic acid can reduce occult blood loss and tourniquet time in obese patients to a greater extent than in patients of normal weight. Therefore, obese knee osteoarthritis patients undergoing TKA can benefit more from tranexamic acid.

Relationship between weight loss in obese knee osteoarthritis patients and serum biomarkers of cartilage breakdown: secondary analyses of a randomised trial.

To explore effects of weight loss and maintenance on serum cartilage biomarkers denaturation neoepitope for Collagen2 (Coll2-1) and Fibulin3 fragment (Fib3-2), as well as correlations between Coll2-1 and Fib3-2 and symptomatic improvement, in a knee osteoarthritis (KOA) population. 192 obese KOA patients followed a 16 week weight loss intervention and 52 weeks weight maintenance (ClinicalTrials.gov identifier: NCT00655941). Assessments were at 0, 8, 16 and 68 weeks. Serum Coll2-1 and Fib3-2 were determined with ELISA, and symptoms by the Knee Osteoarthritis Outcome Score (KOOS) questionnaire. Changes from week 0 and association between changes from baseline in body weight and Coll2-1, Fib3-2, and the 5 KOOS domains were assessed at all time points. Coll2-1 changes from baseline showed a decrease at week 8 (P=0.0002), no change at week 16 (P=0.49), and an increase at week 68 (P=0.036). Fib3-2 showed an increase from baseline at week 8 (P=0.0015) and 16 (P<0.0001), but none at week 68 (P=0.23). No statistically significant correlations were found between changes in body weight and Coll2-1 and Fib3-2 at any time point (r<0.05; P>0.49). At all time-points there were significant positive correlations between changes from baseline in Coll2-1 and in KOOSSports/Recreation (week 8, 16, 68: r=0.17; P=0.03; r=0.16; P=0.04; and r=0.17; P=0.04, respectively). The clinical improvement after a substantial weight loss and weight maintenance in KOA patients was not associated with decrease in markers of cartilage breakdown Coll2-1 or Fib3-2, even with indications of a slightly negative effect.

Relationship between weight loss in obese knee osteoarthritis patients and serum biomarkers of cartilage breakdown: secondary analyses of a randomised trialbetween weight loss in obese knee osteoarthritis patients and serum biomarkers of cartilage breakdown: secondary analyses of a randomised trial

Relationship between weight loss in obese knee osteoarthritis patients and serum biomarkers of cartilage breakdown: secondary analyses of a randomised trialbetween weight loss in obese knee osteoarthritis patients and serum biomarkers of cartilage breakdown: secondary analyses of a randomised trial

Correlation between serum leptin, cytokines, cartilage degradation and functional impact in obese knee osteoarthritis patients

Aim of the workThe aim of the present work was to correlate between serum level of leptin, matrix metalloproteinase-13 (MMP13), interleukin-1β (IL1β), tumour necrosis factor (TNF-α), nitric oxide (NO) and functional impact in obese patients with knee osteoarthritis (KOA). Patients and methodsThe study included 84 obese patients suffering from primary KOA. The knees were examined; pain assessed by visual analogue scale (VAS) and Lequesne’s index for functional impact calculated. Serum leptin, MMP13, IL1β, TNF-α and NO were assessed. ResultsThe mean age of the patients was 54.64±7.7years. They were 72 females and 12 males (F:M=6:1) with a mean BMI of 35.29±4.8. Sixty patients had knee effusion which was bilateral in 54 (64.3%), unilateral in 6 (7.2%) while 24 (28.6%) did not have any effusion. Knee deformities were present in 60 (71.4%) patients. Female patients were only significantly higher than males regarding Lequesne’s index (15.08±4.4 vs 11±3.4, p=0.003). Patients with knee deformity had significantly higher VAS (9.12±1.3 vs 6.96±0.46, p=0.001), IL1β (621.1±98.8 vs 503.9±74.6pg/ml, p=0.001), TNF-α (115.4±29.1 vs 87.4±4.4pg/ml, p=0.001), NO (67.32±5.7 vs 59.2±2.2μmol/L, p=0.001), MMP13 (33.98±2.24 vs 30.1±1.7ng/ml, p=0.012) and leptin (13.2±1.6 vs 10.4±0.6, p=0.004) than those without. The VAS, Lequesne index, IL1β, TNF-α NO, MMP13 and leptin were significantly higher in patients with bilateral knee effusion (p<0.0001 for all) compared to those with unilateral effusion or without. Leptin significantly correlated with BMI, VAS, Lequesne’s index, IL1β, TNFα, NO and MMP13 (p<0.0001 for all). ConclusionLeptin plays a key role in obese patients with knee OA. It significantly correlates with knee pain, functional impairment, inflammatory cytokines and cartilage degradation.

Effect of a 16 weeks weight loss program on osteoarthritis biomarkers in obese patients with knee osteoarthritis: a prospective cohort study

Changes in biomarkers for bone and cartilage in knee osteoarthritis (KOA) may reflect changes in tissue turnover induced by interventions. The aim of this study was to assess the effect on osteoarthritis biomarkers of an intensive weight loss intervention in obese KOA patients. 192 obese KOA patients followed a 16 weeks weight loss intervention (ClinicalTrials.gov: NCT00655941). Serum Cartilage Oligomeric Matrix Protein (sCOMP), Urine C-terminal telopeptide of collagen type II (uCTX-II) and type I (uCTX-I) were determined by enzyme-linked immunoassay (ELISA) at baseline and after 16 weeks. Patient-reported symptoms were assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS) Questionnaire without the sports and recreation score (KOOS-4). Change from baseline was analyzed using Analysis of CoVariance (ANCOVA) adjusting for sex, age, and body mass index (BMI). Bivariate associations were analyzed using Spearman's test of rank correlation. 175 patients completed the treatment and lost mean 13.4 (95% CI: 12.5-14.4) kg. sCOMP concentration decreased on average 1.1 (95% CI:-1.5 to-0.8) U/L with a correlation to weight loss (r=-0.17, P=0.028), but not to change in KOOS-4 (r=-0.13, P=0.091). uCTX-II increased significantly, mean 69 (95% CI: 31-106) ng/mmol creatinine, with no relation to weight loss (P=0.14). Change in uCTX-II was reversely related to change in KOOS-4 (r=-0.28, P=0.0003). uCTX-I increased, mean 67 (95% CI: 47-87) μg/mmol creatinine, and correlated to weight loss (r=0.22, P=0.0007), while not to KOOS-4 (P=0.93). A rapid substantial weight loss in obese KOA patients was weakly, while significantly associated with a reduction in sCOMP, and increases in both uCTX-II and uCTX-I.

Erratum to: The effects of an oral preparation containing hyaluronic acid (Oralvisc®) on obese knee osteoarthritis patients determined by pain, function, bradykinin, leptin, inflammatory cytokines, and heavy water analyses

The purpose of this study was to determine the effects of an oral preparation containing hyaluronic acid on osteoarthritic knee joint pain and function as well as changes in inflammatory cytokines, bradykinin, and leptin. We also used heavy water to determine the turnover rates of glycosaminoglycans in synovial fluid. This was a double-blind, randomized, placebo-controlled study of 40 subjects over a period of 3 months. Visual analog scale, Western Ontario McMaster pain, and WOMAC function scores were recorded. Serum and synovial fluid were measured by enzyme-linked immunosorbent assays for inflammatory cytokines, bradykinin, and leptin. In 20 subjects, terminal heavy water ingestion was used for spectral analyses of serum and joint fluid samples. There were statistically significant improvements in pain and function. Both serum and synovial fluid samples showed significant decreases for a majority of inflammatory cytokines, leptin, and bradykinin in the oral hyaluronic acid preparation group. Heavy water analyses revealed a significant decrease in hyaluronic acid turnover in the synovial fluid of the treatment group. A preparation containing hyaluronic acid and other glycosaminoglycans holds promise for a safe and effective agent for the treatment for patients with knee osteoarthritis and who are overweight. Further studies will be required to see whether this is a disease-modifying agent.

The effects of an oral preparation containing hyaluronic acid (Oralvisc®) on obese knee osteoarthritis patients determined by pain, function, bradykinin, leptin, inflammatory cytokines, and heavy water analyses.

The purpose of this study was to determine the effects of an oral preparation containing hyaluronic acid on osteoarthritic knee joint pain and function as well as changes in inflammatory cytokines, bradykinin, and leptin. We also used heavy water to determine the turnover rates of glycosaminoglycans in synovial fluid. This was a double-blind, randomized, placebo-controlled study of 40 subjects over a period of 3 months. Visual analog scale, Western Ontario McMaster pain, and WOMAC function scores were recorded. Serum and synovial fluid were measured by enzyme-linked immunosorbent assays for inflammatory cytokines, bradykinin, and leptin. In 20 subjects, terminal heavy water ingestion was used for spectral analyses of serum and joint fluid samples. There were statistically significant improvements in pain and function. Both serum and synovial fluid samples showed significant decreases for a majority of inflammatory cytokines, leptin, and bradykinin in the oral hyaluronic acid preparation group. Heavy water analyses revealed a significant decrease in hyaluronic acid turnover in the synovial fluid of the treatment group. A preparation containing hyaluronic acid and other glycosaminoglycans holds promise for a safe and effective agent for the treatment for patients with knee osteoarthritis and who are overweight. Further studies will be required to see whether this is a disease-modifying agent.

Altered Visual and Feet Proprioceptive Feedbacks during Quiet Standing Increase Postural Sway in Patients with Severe Knee Osteoarthritis

ObjectiveThe objective was to investigate how postural control in knee osteoarthritis (KOA) patients, with different structural severities and pain levels, is reorganized under different sensory conditions.MethodsForty-two obese patients (BMI range from 30.1 to 48.7 kg*m−2, age range from 50 to 74 years) with KOA were evaluated. One minute of quiet standing was assessed on a force platform during 4 different sensory conditions, applied 3 times at random: Eyes open (EO) and eyes closed (EC) standing on firm and soft (foam) surfaces (EO-soft and EC-soft). Centre of pressure (Cop) standard deviation, speed, range and Cop mean position in both directions (anterior-posterior and medial-lateral) were extracted from the force platform data. Structural disease severity was assessed from semiflexed standing radiographs and graded by the Kellgren and Lawrence (KL) score. Pain intensity immediately before the measurements was assessed by numeric rating scale (range: 0–10).ResultsThe patients were divided into “less severe” (KL 1 and 2, n = 24) and “severe” (KL>2, n = 18) group. The CoP range in the medial-lateral direction was larger in the severe group when compared with the less severe group during EC-soft condition (P<0.01). Positive correlation between pain intensity and postural sway (range in medial-lateral direction) was found during EC condition, indicating that the higher the pain intensity, the less effective is the postural control applied to restore an equilibrium position while standing without visual information.ConclusionThe results support that: (i) the postural reorganization under manipulation of the different sensory information is worse in obese KOA patients with severe degeneration and/or high pain intensity when compared with less impaired patients, and (ii) higher pain intensity is related to worse body balance in obese KOA patients.

Changes in bone marrow lesions in response to weight-loss in obese knee osteoarthritis patients: a prospective cohort study

BackgroundPatients are susceptible for knee osteoarthritis (KOA) with increasing age and obesity and KOA is expected to become a major disabling disease in the future. An important feature of KOA on magnetic resonance imaging (MRI) is changes in the subchondral bone, bone marrow lesions (BMLs), which are related to the future degeneration of the knee joint as well as prevalent clinical symptoms. The aim of this study was to investigate the changes in BMLs after a 16-week weight-loss period in obese subjects with KOA and relate changes in BMLs to the effects of weight-loss on clinical symptoms.MethodsThis prospective cohort study included patients with a body mass index ≥ 30 kg/m2, an age ≥ 50 years and primary KOA. Patients underwent a 16 weeks supervised diet program which included formula products and dietetic counselling (ClinicalTrials.gov: NCT00655941). BMLs in tibia and femur were assessed on MRI before and after the weight-loss using the Boston-Leeds Osteoarthritis Knee Score. Response to weight-loss in BML scores was dichotomised to patients experiencing a decrease in BML scores (responders) and patients who did not (non-responders). The association of BMLs to weight-loss was assessed by logistic regressions and correlation analyses.Results39 patients (23%) were classified as responders in the sum of all BML size scores whereas 130 patients (77%) deteriorated or remained stable and were categorized as non-responders. Logistic regression analyses revealed no association between weight-loss < or ≥ 10% and response in BMLs in the most affected compartment (OR 1.86 [CI 0.66 to 5.26, p=0.24]). There was no association between weight-loss and response in maximum BML score (OR 1.13 [CI 0.39 to 3.28, p=0.81]). The relationship between changes in BMLs and clinical symptoms revealed that an equal proportion of patients classified as BML responders and non-responders experienced an OMERACT-OARSI response (69 vs. 71%, p=0.86).ConclusionsWeight-loss did not improve the sum of tibiofemoral BML size scores or the maximum tibiofemoral BML score, suggesting that BMLs do not respond to a rapidly decreased body weight. The missing relationship between clinical symptoms and BMLs calls for further investigation.

The association between pressure-pain tolerance threshold and local and/or systemic inflammation in obese knee osteoarthritis patients: a cross-sectional study

samples, simple protocols, and widely available equipment. CICs containing PGE2 and IL-18 were found in the serum of 81% and 65% of kOA patients. Serum PGE2-IgG and IL-18-IgG are significantly higher in the kOA group than those in the control group (P<0.01). A significant positive correlation was noted between their expressions (r1⁄40.863, P<0.01). No correlation between the serum PGE2-IgG and IL-6-IgG was found. Deficiency in the sera ACE-IgM predisposes the expression of high affinity PGE2-IgG in kOA patients. There was a negative correlation between serum PGE2-IgG and ACE-IgM in kOA patients (r1⁄4-0.58, P<0.05). No statistically significant differences were found between serum levels of biomarker-IgM and biomarker-IgA for kOA patients. Conclusions: Blood still represents an ideal clinical source of markers because of its known role in reflecting systemic changes associated with disease. Improved analytical methods are required to accommodate the analysis of large numbers of samples for biological and epidemiological monitoring. Our method may be generally applicable to the study of the relationship between CICs and kOA diseases. The ICs in the serum of a majority of the OA patients contained PGE2 or ACE, and these ICs may have potential as alternative biomarkers. The role of ACE-IgM and PGE2IgG in the modulation of the immune response, pain and inflammation has been regarded as important. The biomarkers in combination (ACE-IgM and PGE2-IgG) work better.

Cardiovascular risk factor changes following three different maintenance programs in obese knee osteoarthritis patients after a major weight loss: a randomized controlled trial

Cardiovascular risk factor changes following three different maintenance programs in obese knee osteoarthritis patients after a major weight loss: a randomized controlled trial

Prevention of knee osteoarthritis in overweight females; the first preventive randomized controlled trial

Prevention of knee osteoarthritis in overweight females; the first preventive randomized controlled trial