OA is a common age-related disease, marked by degradation of joint cartilage. OA of the hip and knee can be particularly disabling because of related pain and functional impairment. The effects of obesity on musculoskeletal diseases are often overlooked, despite evidence that maintaining an ideal body weight benefits joints.
The study was carried out by Flavia Cicuttini of Monash University in Melbourne, Australia. She stated, "The obesity epidemic occurring in developed countries is likely to have a significant impact on the future demands for knee and hip replacement for osteoarthritis and understanding the mechanism of action will be important in effective prevention of osteoarthritis."
The researchers recruited around 39,000 men and women, aged 40-69 years and monitored them over a period of 15 years. By the end of the study, they observed that nearly 1009 joint replacements were carried out, which included 541 knee replacements and 468 hip replacements.
Patients who underwent hip and knee replacements had a significantly higher rate of obesity, with a body mass index
define (BMI) of over 29.2. The researchers found that people who were obese were three times more likely to get hip or knee joint replacements, compared to people with an acceptable BMI of 23.2 for women and 24.7 for men.
The study also revealed that people who were overweight with fat mass of more than 32.9 in men and 27.9 in women were twice as likely to have a joint replacement.
Excess weight tends to put undue stress on joints. Cicuttini stated, "The risk of primary knee replacement and hip joint replacement for osteoarthritis appears to be related to BMI,"
"Adipose (fat) mass contributes to increased joint loading which may increase the risk of osteoarthritis progression and subsequent joint replacement for severe end-stage osteoarthritis,"
The researchers reflected that obesity and overweight besides increasing the need of a joint replacement, also has a negative impact on the recovery of the patient. It accelerates the necessity for repeat surgeries and modifications of the artificial joints, as the extra weight adds more wear and tear on the prostheses.
Professor Alan Silman, medical director of the Arthritis Research Campaign said "Joint replacement surgery is already one of the most common types of surgical procedure, with 65,000 knee replacements and a similar number of hip replacements carried out in the UK every year. If the level of obesity continues at its current rate the NHS could be swamped by the need for this type of surgery."
Professor Silman felt the report was an eye opener, highlighting an urgent need for non surgical techniques to reduce joint replacement, such as cartilage transplantation and tissue regenerated by stem cells.
The study was published in Bio Med Central's open access journal, Arthritis Research & Therapy.
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