OP0094 WEIGHT LOSS: THE TREATMENT OF CHOICE FOR KNEE OSTEOARTHRITIS? A RANDOMISED TRIAL
R. Christensen, A. Astrup, H. Bliddal; Denmark

Weight loss is suspected to help reduce the pain in patients with knee osteoarthritis (OA). In this study, Bliddal et al evaluate the effect of rapid diet-induced weight loss on pain and function in obese knee OA patients. Presented were 8 week outcome data.

Methods: 96 patients were randomized according to age, gender and body mass index (BMI). 89 patients meeting ACR criteria for knee OA, having grade 2 or 3 on the Kelgren scale, and a BMI =28 kgm2 were randomized to either a low energy diet (LED 3.4 mJ/day) or to a control diet (CD 5mJ/day). The LED diet consisted of 6 daily meals of a powdered diet dissolved into water (37% protein, 47% carbohydrate, 16% vegetable fat, and 16g/day oat-bran fiber.) At baseline, both groups received a single dietary counseling session. However, the LED group continued with weekly sessions, while the CD group was given a booklet describing weight loss techniques.

Changes in body weight and composition were measured by dual-energy x-ray and bioimpedance, and symptoms were assessed by the WOMAC OA index.

Results: There was a 9% dropout rate in both of the groups, mainly due to non-compliance and lack of motivation. The LED and the CD group lost significant weight, mean (SE) 11.1% (0.6) and 4.3% (0.6), respectively, with a mean difference between the groups of 6.8% (95%[1:55 to 8.1%; p<0.0001]). Percent body fat was reduced more in the LED group, 2.2%(1.5 to 3.0%; p<0.0001).

At baseline, the WOMAC index score for the LED group was 950.

Conclusion: Although this study is based on a liquid diet with rapid weight loss, these data show that some obese patients with knee OA can improve their knee function and reduce pain with weight loss, as measured using standardized analysis. A 10% reduction in weight can lead to a 28% improvement in function.

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