Effects of an intensive weight loss program on knee joint loading in obese adults with knee osteoarthritis

Objective: To determine the effect of an intensive weight loss program on knee joint loads during walking in obese patients with knee osteoarthritis (OA). Methods: Participants included 157 obese knee OA patients that underwent a 16-week dietary intervention. Three-dimensional gait analyses were performed before and after the intervention at the participants' freely chosen walking speed. Knee joint compression forces, axial impulses, knee flexion angle and frontal and sagittal plane knee moments were calculated to determine the biomechanical effects of the weight loss. Results: 157 subjects (89% of the initial cohort) completed the 16-week intervention. The average weight loss of 13.7 kg (P<.0001) corresponded to 13.5% of the baseline body weight. The weight loss resulted in a 7% reduction in knee joint loading, a 13% lower axial impulse, and a 12% reduction in the internal knee abductor moment (KAM). There were no clear effects on sagittal plane knee moments or peak knee flexion angle. Linear regression analyses adjusted for changes in walking speed showed that for every 1 kg in weight loss, the peak knee load was reduced by 2.2 kg. Thus, every kilo reduction in body weight was related to more than twice the reduction in peak knee force at a given walking speed. Conclusion: Weight loss is an excellent short-term investment in terms of joint loading for patients with combined obesity and knee OA. The effects of sustained weight loss on disease progression and symptoms in relation to biomechanical factors remain to be shown. (C) 2011 Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.