Association between body mass index and severity of primary knee osteoarthritis: A hospital-based cross-sectional study.
DOI:
https://doi.org/10.51168/m965hg24Cuvinte cheie:
Body mass index, obesity, primary knee osteoarthritis, Kellgren–Lawrence grade, Western Ontario and McMaster Universities Osteoarthritis Index, pain, functional limitationRezumat
Background:
Obesity is an important modifiable factor in primary knee osteoarthritis, although its relationship with radiographic severity, pain, and functional limitation varies across clinical populations.
Objectives:
To determine the association between body mass index and the radiographic and clinical severity of primary knee osteoarthritis.
Methods:
This hospital-based cross-sectional study included 100 adults with symptomatic primary knee osteoarthritis at Government Medical College/Government General Hospital, Nizamabad, Telangana, from October 2024 to September 2025. Body mass index was classified as normal, overweight or obese. Radiographic severity was graded using the Kellgren–Lawrence system. Pain, functional impairment and knee movement were assessed using a visual analogue scale, the Western Ontario and McMaster Universities Osteoarthritis Index and goniometric knee flexion. Associations were examined using analysis of variance, chi-square tests, correlation analysis and multivariable logistic regression.
Results:
The mean age was 58.6 ± 9.0 years, and 63.0% were women. Normal weight, overweight, and obesity were present in 26.0%, 42.0%, and 32.0%, respectively. Severe osteoarthritis was identified in 19.2% of normal-weight, 47.6% of overweight, and 78.1% of obese participants. Body mass index correlated positively with Kellgren–Lawrence grade, pain and total WOMAC score, and inversely with knee flexion. After adjustment for age, sex, and symptom duration, obesity remained independently associated with severe osteoarthritis (adjusted odds ratio, 8.21; 95% confidence interval, 2.05–32.89).
Conclusion:
Higher body mass index was associated with advanced radiographic disease, greater pain, poorer function and restricted knee movement. Obesity was an independent predictor of severe primary knee osteoarthritis.
Recommendations:
Routine weight assessment and structured weight-management counselling should be incorporated into knee osteoarthritis care, with longitudinal studies undertaken to clarify temporal and causal relationships.
Referințe
1. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745-1759. https://doi.org/10.1016/S0140-6736(19)30417-9
2. Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(7):1323-1330. https://doi.org/10.1136/annrheumdis-2013-204763
3. Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis: the Framingham Study. Ann Intern Med. 1988;109(1):18-24. https://doi.org/10.7326/0003-4819-109-1-18
4. Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001;25(5):622-627. https://doi.org/10.1038/sj.ijo.0801585
5. Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2010;18(1):24-33. https://doi.org/10.1016/j.joca.2009.08.010
6. Zheng H, Chen C. Body mass index and risk of knee osteoarthritis: systematic review and meta-analysis of prospective studies. BMJ Open. 2015;5(12):e007568. https://doi.org/10.1136/bmjopen-2014-007568
7. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum. 1986;29(8):1039-1049. https://doi.org/10.1002/art.1780290816
8. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494-502. https://doi.org/10.1136/ard.16.4.494
9. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient-relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833-1840.
10. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573-577. https://doi.org/10.7326/0003-4819-147-8-200710160-00010
11. Dong Y, Yan Y, Zhou J, Zhou Q, Wei H. Evidence on risk factors for knee osteoarthritis in middle-older aged: a systematic review and meta-analysis. J Orthop Surg Res. 2023;18(1):634. https://doi.org/10.1186/s13018-023-04089-6
12. Weiss E. Knee osteoarthritis, body mass index and pain: data from the Osteoarthritis Initiative. Rheumatology (Oxford). 2014;53(11):2095-2099. https://doi.org/10.1093/rheumatology/keu244
13. Cubukcu D, Sarsan A, Alkan H. Relationships between pain, function and radiographic findings in osteoarthritis of the knee: a cross-sectional study. Arthritis. 2012;2012:984060. https://doi.org/10.1155/2012/984060
14. Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, DeVita P, et al. 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. 2013;310(12):1263-1273. https://doi.org/10.1001/jama.2013.277669
Descărcări
Publicat
Număr
Secțiune
Licență
Copyright (c) 2026 Dr. Raghavendra Chidrawar, Dr. K. Venkata Santosh Reddy
TAceastă lucrare este licențiată în temeiul Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
