Bariatric Surgery Improved Knee OA Symptoms

Major Finding: At 6 months after bariatric surgery, patients had a 20% drop from baseline BMI and their average serum level of procollagen type II N-terminal propeptide (PIIANP), a marker of cartilage synthesis, had risen 32%, while their average serum level of cartilage oligomeric matrix protein (COMP) had decreased by 36%.

Data Source: Baseline and 6-month follow-up measures in 36 women and 8 men who underwent bariatric surgery for obesity (average baseline BMI of 50.7) and had moderate to severe knee osteoarthritis.

Disclosures: The study was funded by Assistance Publique-Hôpitaux de Paris, Direction of Clinical Research, which promoted and supported the clinical investigation, a grant from the European community, and the Association Rhumatisme et Travail (Hôpital Lariboisière, Paris). The authors reported no financial conflicts of interest.

In obese patients with knee osteoarthritis, significant weight loss after bariatric surgery reduced pain and stiffness, decreased low-grade inflammation, and changed cartilage turnover, according to a small study.

In addition to the well-known relationship between obesity and onset of knee osteoarthritis (OA), several studies have now shown that the association goes beyond the increase in mechanical load on the tibiofemoral cartilage. “Adipose tissue may act as an endocrine organ, releasing several proinflammatory mediators and adipokines in blood that may participate in cartilage alteration in obese patients,” according to Dr. Pascal Richette of Hôpital Lariboisière and coauthors. “Trials that have assessed the efficacy of surgically induced massive weight loss on knee OA symptoms are scarce and have not specifically included patients with well-defined radiographic evidence of knee OA, as in our study.” (Ann. Rheum. Dis. 2011;70:139-44).

The authors studied 44 obese patients (36 women) with a baseline body mass index of 50.7 before surgery and moderate to severe knee OA. The patients underwent laparoscopic Roux-en-Y gastric bypass surgery or laparoscopic adjustable gastric banding. Patient data were collected before and 6 months after surgery.

At 6 months, patients had a 20% drop from baseline BMIs. Their VAS (visual acuity scores) decreased from 50 mm to 24.5 mm and their scores on the WOMAC (Western Ontario MacMaster) Questionnaire improved. Significant decreases were seen in average serum levels of interleukin-6 (IL-6), which declined by 26%, and of high-sensitivity C-reactive protein (hsCRP), which dropped 46%. Also, weight loss was associated with changes in adipokine levels: Mean serum leptin concentration was decreased by 48%, and serum level of adiponectin was increased by 21%, the authors reported.

The average serum level of procollagen type II N-terminal propeptide (PIIANP), a marker of cartilage synthesis, rose 32%, while the serum level of cartilage oligomeric matrix protein (COMP) decreased by 36%. “These results are the first to suggest a benefit of weight loss on both cartilage anabolism and catabolism,” the authors wrote.

The researchers found a significant correlation between IL-6 level and WOMAC Questionnaire scores as well as between urinary type II collagen helical peptide (helix-II) and hsCRP. Variation in COMP concentration was significantly correlated with changes in VAS pain scores and WOMAC stiffness score, the authors wrote, adding, “Our findings extend the results of recent work showing a significant association of IL-6 circulating levels and the prevalence and incidence of knee OA.”

Major Finding: At 6 months after bariatric surgery, patients had a 20% drop from baseline BMI and their average serum level of procollagen type II N-terminal propeptide (PIIANP), a marker of cartilage synthesis, had risen 32%, while their average serum level of cartilage oligomeric matrix protein (COMP) had decreased by 36%.

Data Source: Baseline and 6-month follow-up measures in 36 women and 8 men who underwent bariatric surgery for obesity (average baseline BMI of 50.7) and had moderate to severe knee osteoarthritis.

Disclosures: The study was funded by Assistance Publique-Hôpitaux de Paris, Direction of Clinical Research, which promoted and supported the clinical investigation, a grant from the European community, and the Association Rhumatisme et Travail (Hôpital Lariboisière, Paris). The authors reported no financial conflicts of interest.

In obese patients with knee osteoarthritis, significant weight loss after bariatric surgery reduced pain and stiffness, decreased low-grade inflammation, and changed cartilage turnover, according to a small study.

In addition to the well-known relationship between obesity and onset of knee osteoarthritis (OA), several studies have now shown that the association goes beyond the increase in mechanical load on the tibiofemoral cartilage. “Adipose tissue may act as an endocrine organ, releasing several proinflammatory mediators and adipokines in blood that may participate in cartilage alteration in obese patients,” according to Dr. Pascal Richette of Hôpital Lariboisière and coauthors. “Trials that have assessed the efficacy of surgically induced massive weight loss on knee OA symptoms are scarce and have not specifically included patients with well-defined radiographic evidence of knee OA, as in our study.” (Ann. Rheum. Dis. 2011;70:139-44).

The authors studied 44 obese patients (36 women) with a baseline body mass index of 50.7 before surgery and moderate to severe knee OA. The patients underwent laparoscopic Roux-en-Y gastric bypass surgery or laparoscopic adjustable gastric banding. Patient data were collected before and 6 months after surgery.

At 6 months, patients had a 20% drop from baseline BMIs. Their VAS (visual acuity scores) decreased from 50 mm to 24.5 mm and their scores on the WOMAC (Western Ontario MacMaster) Questionnaire improved. Significant decreases were seen in average serum levels of interleukin-6 (IL-6), which declined by 26%, and of high-sensitivity C-reactive protein (hsCRP), which dropped 46%. Also, weight loss was associated with changes in adipokine levels: Mean serum leptin concentration was decreased by 48%, and serum level of adiponectin was increased by 21%, the authors reported.

The average serum level of procollagen type II N-terminal propeptide (PIIANP), a marker of cartilage synthesis, rose 32%, while the serum level of cartilage oligomeric matrix protein (COMP) decreased by 36%. “These results are the first to suggest a benefit of weight loss on both cartilage anabolism and catabolism,” the authors wrote.

The researchers found a significant correlation between IL-6 level and WOMAC Questionnaire scores as well as between urinary type II collagen helical peptide (helix-II) and hsCRP. Variation in COMP concentration was significantly correlated with changes in VAS pain scores and WOMAC stiffness score, the authors wrote, adding, “Our findings extend the results of recent work showing a significant association of IL-6 circulating levels and the prevalence and incidence of knee OA.”

Major Finding: At 6 months after bariatric surgery, patients had a 20% drop from baseline BMI and their average serum level of procollagen type II N-terminal propeptide (PIIANP), a marker of cartilage synthesis, had risen 32%, while their average serum level of cartilage oligomeric matrix protein (COMP) had decreased by 36%.

Data Source: Baseline and 6-month follow-up measures in 36 women and 8 men who underwent bariatric surgery for obesity (average baseline BMI of 50.7) and had moderate to severe knee osteoarthritis.

Disclosures: The study was funded by Assistance Publique-Hôpitaux de Paris, Direction of Clinical Research, which promoted and supported the clinical investigation, a grant from the European community, and the Association Rhumatisme et Travail (Hôpital Lariboisière, Paris). The authors reported no financial conflicts of interest.

In obese patients with knee osteoarthritis, significant weight loss after bariatric surgery reduced pain and stiffness, decreased low-grade inflammation, and changed cartilage turnover, according to a small study.

In addition to the well-known relationship between obesity and onset of knee osteoarthritis (OA), several studies have now shown that the association goes beyond the increase in mechanical load on the tibiofemoral cartilage. “Adipose tissue may act as an endocrine organ, releasing several proinflammatory mediators and adipokines in blood that may participate in cartilage alteration in obese patients,” according to Dr. Pascal Richette of Hôpital Lariboisière and coauthors. “Trials that have assessed the efficacy of surgically induced massive weight loss on knee OA symptoms are scarce and have not specifically included patients with well-defined radiographic evidence of knee OA, as in our study.” (Ann. Rheum. Dis. 2011;70:139-44).

The authors studied 44 obese patients (36 women) with a baseline body mass index of 50.7 before surgery and moderate to severe knee OA. The patients underwent laparoscopic Roux-en-Y gastric bypass surgery or laparoscopic adjustable gastric banding. Patient data were collected before and 6 months after surgery.

At 6 months, patients had a 20% drop from baseline BMIs. Their VAS (visual acuity scores) decreased from 50 mm to 24.5 mm and their scores on the WOMAC (Western Ontario MacMaster) Questionnaire improved. Significant decreases were seen in average serum levels of interleukin-6 (IL-6), which declined by 26%, and of high-sensitivity C-reactive protein (hsCRP), which dropped 46%. Also, weight loss was associated with changes in adipokine levels: Mean serum leptin concentration was decreased by 48%, and serum level of adiponectin was increased by 21%, the authors reported.

The average serum level of procollagen type II N-terminal propeptide (PIIANP), a marker of cartilage synthesis, rose 32%, while the serum level of cartilage oligomeric matrix protein (COMP) decreased by 36%. “These results are the first to suggest a benefit of weight loss on both cartilage anabolism and catabolism,” the authors wrote.

The researchers found a significant correlation between IL-6 level and WOMAC Questionnaire scores as well as between urinary type II collagen helical peptide (helix-II) and hsCRP. Variation in COMP concentration was significantly correlated with changes in VAS pain scores and WOMAC stiffness score, the authors wrote, adding, “Our findings extend the results of recent work showing a significant association of IL-6 circulating levels and the prevalence and incidence of knee OA.”