Rheumatology Advance Access originally published online on August 18, 2009
Rheumatology 2009 48(10):1290-1293; doi:10.1093/rheumatology/kep246
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Cartilage defects are associated with physical disability in obese adults
1Department of Rheumatology, Institute of Bone and Joint Research, Kolling Institute, 2Department of Rheumatology, Royal North Shore Hospital, 3University of Sydney, Institute of Obesity Nutrition and Exercise, 4Department of Radiology, Royal North Shore Hospital and 5Faculty of Health Sciences, University of Sydney, Sydney, Australia.
Correspondence to: Lyn March, Department of Rheumatology, Building 35, Level 4, Royal North Shore Hospital, St Leonard's, NSW 2065, Australia. E-mail: lynmar{at}med.usyd.edu.au
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Abstract |
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Objective. To describe the associations between physical disability measures and knee cartilage defects in obese adults.
Methods. One hundred and eleven obese subjects were recruited from laparoscopic adjustable gastric banding or exercise/diet weight loss programmes. All subjects completed disease-specific (WOMAC) and general health status (SF-36) questionnaires, and were assessed for range of knee motion, tibiofemoral alignment and quadriceps strength. Knee cartilage defects were graded on MRI according to established protocol. Regression analysis was adjusted for age, gender, BMI and presence of clinical knee OA.
Results. The association between higher whole compartment cartilage defect scores and increasing BMI, age and clinical knee OA was confirmed in this obese cohort (r = 0.27, P = 0.01; r = 0.26, P = 0.007; P < 0.0001, respectively), whereas new associations were found with reduced knee range of motion (r = 0.5, P < 0.0001). No associations were found between defect scores and quadriceps strength. Varus malalignment was associated with higher medial cartilage defect scores (r = 0.33, P = 0.013). Higher levels of pain, stiffness and physical disability (WOMAC, SF-36) were associated with higher medial compartment and patella cartilage defect scores.
Conclusions. Knee cartilage defects increase with increasing obesity and are associated with both objective and self-reported measures of physical disability. Longitudinal studies are required to assess the potential for change or improvement in cartilage defects with weight loss.
KEY WORDS: Cartilage defects, MRI, Obesity, Clinical osteoarthritis, Range of motion, Alignment, Quadriceps strength
Submitted 23 February 2009;
revised version accepted 14 July 2009.
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