Preventing weight gain could reduce knee replacements

A recent study published in Osteoarthritis and Cartilage finds that preventing weight gain from early adulthood could reduce total knee replacements saving the healthcare system $373 million annually.

Senior author and Monash University Professor Flavia Cicuttini, who also heads the School of Public Health and Preventive Medicine’s Musculoskeletal Epidemiology Unit, says, “preventing weight gain is feasible and effective in improving osteoarthritis health outcomes.”

The study led by Monash-University examined the correlation between patterns of weight gain (BMI trajectories) from early adulthood to late midlife and the risk of total knee replacement for osteoarthritis.

The study used data from 24,368 participants in Melbourne. Researchers linked weight data over a period of years with National Joint Replacement Registry records. Over 12.4 years, 1328 (5.4%) subjects had a total knee replacement. The risk of requiring one increased in all groups where someone progressed into a higher-weight group.

In total, 28.4% of knee replacements could be prevented if people moved to one group lower, with an average 8-12kg weight loss from early adulthood to late midlife.

Professor Cicuttini says a “call to action” is needed for knee joint health. “We also need to be sending out the message that it is important to make sure that people don’t continue to gain more weight,” she says. “Although recommendations to lose weight are important if a person is carrying excess weight, this can be difficult to achieve for most people.

“We need to focus on preventing or slowing weight gain when people first present with any knee pain, even niggling knee pain. Australians tend to gain about 0.5-1 kg per year over adult life. This slow, steady accumulation of weight adds up, resulting in the obesity we see.”

Professor Cicuttini says that assuming we can ‘fix’ obesity after it has occurred is not very effective, and prevention has multiple health and cost benefits.

“If an approach doesn’t work, why don’t we change it?” she says. “If adults can be encouraged to consider preventing the slow creep in weight from a young age, this will have multiple health benefits, including reducing the need for a knee replacement in the future.”