Does high weight loss in older adults with knee osteoarthritis affect bone-on-bone joint loads and muscle forces during walking?

Messier, S. P.; Legault, C.; Loeser, R. F.; Van Arsdale, S. J.; Davis, C.; Ettinger, W. H.; DeVita, P.

Affiliations

¹J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA

²Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA

³Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA

⁴Department of Medicine, University of Massachusetts Medical School, North Worcester, MA, USA

⁵Department of Exercise and Sport Science, East Carolina University, Greenville, NC, USA

Abstract and keywords

Objective: The aim of this study was to examine the effects of high weight loss on knee joint loads during walking in participants with knee osteoarthritis (OA).

Design: Data were obtained from a subset of participants enrolled in the Arthritis, Diet, and Activity Promotion Trial (ADAPT). Complete baseline and 18-month follow-up data were obtained on 76 sedentary, overweight or obese older adults with radiographic knee OA. Three-dimensional gait analysis was used to calculate knee joint forces and moments. The cohort was divided into high (>5%), low (<5%), and no (0% or gain) weight loss groups.

Results: From baseline body weight, the high weight loss group lost an average of 10.2%, the low weight loss group lost an average of 2.7%, and the no weight loss group gained 1.5%. Adjusted 18-month outcome data revealed lower maximum knee compressive forces with greater weight loss (P = 0.05). The difference in compressive forces between the high weight loss and no weight loss groups was due primarily to lower hamstring forces (P = 0.04). Quadriceps forces were similar between the groups at 18-month follow-up. There was no difference between the groups in 18-month joint space width or Kellgren–Lawrence scores.

Conclusions: These results suggest that a 10% weight loss in an overweight and obese osteoarthritic population elicits positive changes in the mechanical pathway to knee OA by having lower knee joint compressive loads during walking compared to low and no weight loss groups. The difference in compressive forces was due, in large part, to reductions in hamstring co-contraction during the initial portion of the stance phase.

Keywords: Biomechanics; Gait; Knee joint loads; Musculoskeletal modeling; Knee OA

Links

DOI: 10.1016/j.joca.2010.11.010

PubMed: 21134477

WoS: 000288527300004

History

Received: 2010-03-25

Accepted: 2010-11-26

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Cited By (13)

Year	Entry
2013	Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, DeVita P, Beavers DP, Hunter DJ, Lyles MF, Eckstein F, Williamson JD, Carr JJ, Guermazi A, Loeser RF. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA. September 25, 2013;310(12):1263-1273.
2023	Kaneda JM, Seagers KA, Uhlrich SD, Kolesar JA, Thomas KA, Delp SL. Can static optimization detect changes in peak medial knee contact forces induced by gait modifications? J Biomech. May 2023;152:111569.
2012	Harding GT. Obesity, Moderate Knee Osteoarthritis, and Knee Joint Dynamics [Master's thesis]. Halifax, NS: Dalhousie University; July 2012.
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2014	Adouni M. Analyse biomécanique de l'articulation de genou durant la bipédie humaine [PhD thesis]. École polytechnique de Montréal; July 2014.
2021	Legrand T. Influence des caractéristiques anatomiques individuelles sur les altérations de marche: Impact sur la cinétique articulaire du membre inférieur [PhD thesis]. Université Laval; 2021.
2011	Hoops ML. The Influence of Obesity and Alignment on Knee Joint Loads During Osteoarthritic Gait [Master's thesis]. Winston-Salem, NC: Wake Forest University; May 2011.
2012	Herman C. Differential Effects of Unilateral Versus Bilateral Knee Osteoarthritis on Gait [Master's thesis]. Winston-Salem, NC: Wake Forest University; May 2012.
2013	King J. Association Between Overuse Injury and Biomechanics in Distance Runners [Master's thesis]. Winston-Salem, NC: Wake Forest University; May 2013.
2016	Sabatino AN. Muscle Activation During High and Low Intensity Strength Training in Older Adults With Knee Osteoarthritis [Master's thesis]. Winston-Salem, NC: Wake Forest University; 2016.
2017	Hunzinger KJ. The Influence of Stride Length, Knee Stiffness, and Leg Strength on the Associations Between Bone Mineral Density, Lean and Fat Mass, and Knee Joint Compressive Forces Among Older Adults With Knee Osteoarthritis [Master's thesis]. Winston-Salem, NC: Wake Forest University; May 2017.
2019	Matechik MK. A 2-Year Prospective Cohort Study of Anterior Knee Pain in Runners [Master's thesis]. Winston-Salem, NC: Wake Forest University; May 2019.
2024	Vigliotti M. The Effect of Long-Term Strength Training on Hip and Knee Joint Loading During Gait in Individuals With Knee Osteoarthritis and Varus Alignment [Master's thesis]. Winston-Salem, NC: Wake Forest University; May 2024.