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The effect of weight loss on the progression of meniscal extrusion and size in knee osteoarthritis: a post-hoc analysis of the Intensive Diet and Exercise for Arthritis (IDEA) trial

Munugoda, IP ORCID: 0000-0001-5075-6760, Beavers, DP, Wirth, W, Aitken, DA ORCID: 0000-0001-5685-7634, Loeser, RF, Miller, GD, Lyles, M, Carr, JJ, Guermazi, A, Hunter, DJ, Messier, SP and Eckstein, F 2020 , 'The effect of weight loss on the progression of meniscal extrusion and size in knee osteoarthritis: a post-hoc analysis of the Intensive Diet and Exercise for Arthritis (IDEA) trial' , Osteoarthritis and Cartilage, vol. 28, no. 4 , pp. 410-417 , doi: 10.1016/j.joca.2020.01.006.

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Abstract

Objective: Weight loss has beneficial effects on clinical outcomes in knee osteoarthritis (OA), but the mechanism is still unclear. Since meniscus extrusion is associated with knee pain, this study assessed whether weight loss by diet and/or exercise is associated with less progression in meniscus extrusion measures over time.Design: The Intensive Diet and Exercise for Arthritis trial (IDEA) was a prospective, single-blind, randomized-controlled trial including overweight and obese older adults with knee pain and radiographic OA. Participants were randomized to 18-month interventions: exercise only, diet only or diet + exercise. In a random subsample of 105 participants, MRIs were obtained at baseline and follow-up. The medial and lateral menisci were segmented and quantitative position and size measures were obtained, along with semiquantitative extrusion measures. Linear and log-binomial regression were used to examine the association between change in weight and change in meniscus measures. Between-group differences were analyzed using an analysis of covariance.Results: Weight loss was associated with less progression over time of medial meniscus extrusion as measured by the maximum (β: -24.59 μm, 95%CI: -41.86, -7.33) and mean (β: -19.08 μm, 95%CI: -36.47, -1.70) extrusion distances. No relationships with weight loss were observed for lateral meniscus position, medial or lateral meniscus size or semiquantitative measures. Change in meniscus position and size did not differ significantly between groups.Conclusions: Weight loss was associated with beneficial modifications of medial meniscus extrusion over 18 months. This may be one of the mechanisms by which weight loss translates into a clinical benefit.

Item Type: Article
Authors/Creators:Munugoda, IP and Beavers, DP and Wirth, W and Aitken, DA and Loeser, RF and Miller, GD and Lyles, M and Carr, JJ and Guermazi, A and Hunter, DJ and Messier, SP and Eckstein, F
Keywords: knee osteoarthritis, meniscus extrusion, obesity, quantitative MRI, weight loss
Journal or Publication Title: Osteoarthritis and Cartilage
Publisher: W B Saunders Co Ltd
ISSN: 1063-4584
DOI / ID Number: 10.1016/j.joca.2020.01.006
Copyright Information:

Copyright 2020 Osteoarthritis Research Society International

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