Weight loss for obese patients as a treatment of hip and knee osteoarthritis: A scoping review

Abstract

Background: The American Academy of Orthopaedic Surgeons (AAOS) has been recommending a weight loss of 5% of body weight or more as a treatment for those who have osteoarthritis (OA). However, the AAOS does not recommend or guide clinicians in the best weight loss strategies, leaving the clinician and the patients on their own to navigate the weight loss process. Aim: This scoping review addresses the most effective ways to reach the recommended weight loss and achieve symptomatic improvement through various methods, including diet, exercise, meal replacements and specific diet types, with or without the help of a trained professional. Methods: In a scoping literature review, this author investigated medication use, diet, exercise or a combination of diet and exercise as an effective method for weight loss to treat hip and knee osteoarthritis and whether the delivery method (i.e., telehealth or application-based versus in-person) played a role in the effectiveness of weight loss. Results: A loss of body weight between 10% and 20% results in more significant symptomatic improvement and is safe and effective with the help of a trained health care professional and meal replacement foods. Conclusion: A clear dose response exists between the amount of weight lost and symptomatic improvement, with better symptomatic improvement seen in patients losing more than the typically recommended 5% body weight. Contribution: This review shows that a weight loss of 10–20% of body weight through a low carbohydrate diet combined with exercise can effectively be used as symptomatic management of hip or knee osteoarthritis.

Keywords

• osteoarthritis
• obesity
• total joint replacement
• total joint arthroplasty
• weight loss