Content provided by the Faculty of the Harvard Medical School
Obese people with arthritic knees have about 3 1/2 fewer years of able, pain-free life than slim people with healthy knees. That estimate comes from a new study. It focused on U.S. adults ages 50 to 84. Researchers used census data and other sources. They made estimates of how long people live with obesity and knee osteoarthritis. They also calculated how much of that time is hampered by pain and disability. For example, people may have trouble walking. The study found that obese people with arthritic knees lose an average of 3 1/2 healthy years. For obese people without knee problems, the loss is 2 1/2 healthy years. People with knee arthritis and normal weight lose nearly 2 years of good health, the study found. The journal Annals of Internal Medicine published the study. HealthDay News wrote about it February 14.
What Is the Doctor's Reaction?
Similar to most doctors, I encourage overweight and obese patients to lose weight by pointing out the health risks. Here are some of the ones linked with obesity:
- Diabetes
- High blood pressure
- Heart disease
- Certain cancers, such as breast cancer in women and the more aggressive types of prostate cancer in men
These are conditions that shorten life span. But today many people are concerned with quality of life as they age, even more than how long they live.
Some medical conditions severely reduce quality of life. Osteoarthritis, especially in the knees, is high on this list. Yet I usually don't mention the link between weight and knee osteoarthritis until an overweight person complains about knee pain.
A new study reminds us how much the combination of obesity and osteoarthritis of the knee can reduce quality of life. The journal Annals of Internal Medicine published the study February 15.
Osteoarthritis breaks down cartilage. This is the tissue that covers and protects the ends of bones. Osteoarthritis can appear in many joints. The risk is higher for the knee because it bears weight. This means it is subject to daily wear and tear as well as sudden injury.
Why do some people get osteoarthritis while others don't? Excess weight is a major reason. Demanding physical activity earlier in life plays a role. So do your genes. If your parents or grandparents had arthritis, you are more likely to develop it yourself.
Gender, race and ethnicity also make a difference. Women are more likely to develop knee osteoarthritis than men. Obese black women have a higher risk than white and Asian women with similar body weights.
What Changes Can I Make Now?
Knee osteoarthritis can happen to anyone. Today 1 out of 3 people over age 62 has some amount of osteoarthritis in one or both knees. Obesity has been rising quickly. So the percentage of people with osteoarthritis of the knee will surely increase.
People will lose an average of 3 ½ years of being pain-free if they become obese and also develop knee osteoarthritis. Obesity is defined as a body mass index (BMI) of 30 or greater. If you have a family history of knee osteoarthritis, you probably will have a reduced quality of life for even longer. Prior knee injury or prolonged physical demands on your knees also increase the number of quality years lost.
You can't totally prevent knee osteoarthritis if you are destined to have it. But you can delay how soon your symptoms begin. You also have a good chance of preventing it from becoming severe and disabling.
Obviously, you should lose weight if needed. Exercise is equally important, even if you have trouble losing weight. Regular exercise can strengthen the muscles around the knees. The stronger and bigger muscles can absorb much of the day to day trauma your knees endure.
Choose the right kind of exercise. You probably should avoid running and fast walking on the sidewalk or pavement. If you love jogging or fast walking, do it on a track or treadmill. Wear well-cushioned shoes to help reduce the impact on your knees. Consider cycling or swimming, which may be better choices.
Also do leg resistance training 2 to 3 times per week. Using weight machines, such as Cybex or Nautilus, strengthens the muscles around the knees. Range-of-motion exercises help maintain joint function. They also help prevent stiffness.
What Can I Expect Looking to the Future?
Osteoarthritis has no cure. So we must focus on preventing knee pain and disability. Knee replacement is a last resort. But the number of knee replacements will continue to rise until more people maintain a healthy weight and do the right kinds of exercise.
Growing new cartilage probably will happen. It can be done now in the laboratory. But implanting new cartilage and getting it to grow inside the knee remains a challenge.
Last Annual Review Date: Feb 16, 2011Copyright: Harvard Health Publications
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