Changes in Knee Pain, Perceived Need for Surgery, Physical Function and Quality of Life after Dietary Weight Loss in Obese Women Diagnosed with Knee Osteoarthritis
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Purpose: The objective of this study was two-fold: 1) to investigate whether weight loss is associated with a reduction in perceived need for Total Knee Replacement (TKR) surgery due to decrease in knee pain and improvement in function, 2) to identify what percentage of weight loss is associated with reduction in knee pain to a point where the need for surgery could be prolonged or alleviated. 34 subjects were recruited into the study. Methods: Women between 40 and 65 years old with morbid obesity (BMI ≥ 35 kg/m2) and osteoarthritis of the knee were pre-selected. Participants completed the Western Ontario and McMasters (WOMAC) Universities index, The Short Form Health Survey (SF-36); 6-Minute Walk Test and Timed Up and Go at baseline and participants were enrolled into a weight loss program, for a 6 month period. Results: Repeated measures ANOVA revealed that at 6 weeks of diet the mean body weight reduction of 9.5%, was followed by a significant reduction (p=.015) in WOMAC scores and (p=.038) SF-36 sub score of physical function. At 3 months of diet a significant reduction of 16.5% in body weight corresponded to a significant decrease of 37% in knee pain and 56% in perceived need for surgery. Conclusion: These results suggest that an initial loss of 16.5% of body weight for obese individuals was significant enough to reduce pain and postpone patient's intent to have surgery in 56%. Even though a weight loss of 16.5% might influence a patient's choice to undergo TKR surgery, these findings might not be extended to the general morbidly obese population. However, based on our results we expect that a weight loss of 16.5% might provide a major decrease in knee pain and increase in function.