More Muscle, Less Fat Equal Milder Knee Osteoarthritis?

What is the role of the thigh muscles and adipose tissues in the progression of knee osteoarthritis (OA) in women?

This is the question researchers delved into with their recent study, “The role of thigh muscle and adipose tissue in knee osteoarthritis progression in women.” This study appears in the June 8, 2018 edition of Osteoarthritis and Cartilage.

Co-author, Jana Kemnitz, M.Sc,, Paracelsus Medical University, Institute of Anatomy Salzburg & Nuremberg, Salzburg, Austria told OTW, “Knee osteoarthritis is known to involve multiple interactive pathways and is therefore considered a disease of the whole joint or even limb. While it is well known that thigh muscle deficits are a common feature in knee osteoarthritis, the role of thigh muscles and (local) adiposity in the ongoing disease process (e.g., radiographic and symptomatic progression) remains unclear but may offer a potential target for therapeutic interventions.”

“The most intriguing findings were that a concurrent loss of muscle mass occurs with symptomatic progression and a concurrent gain of intermuscular adipose tissue occurs with radiographic progression in women with knee osteoarthritis.”

Lose Weight to Slow OA Progression

“These results suggest that muscles and adipose tissue are involved in the pathogenesis of knee osteoarthritis. Importantly, unlike many other tissues, muscles and intermuscular adiposity can be modified by training intervention and weight loss and may thus provide a non-invasive and non-pharmacological treatment opportunity for both symptomatic and radiographic knee osteoarthritis progression in women.”

“Knee osteoarthritis should be considered as an ongoing disease process and training and weight loss modification provide a non-invasive therapy particularly in women. OARSI [Osteoarthritis Research Society International] Guidelines by McAlindon et al., have recommended non-invasive therapy treatment modalities for all individuals with knee osteoarthritis including biomechanical interventions, exercise, self-management and education, strength training, and weight management to delay or avoid the final joint-death.”

“Surgeons may counsel those patients not yet at the end stage of final ‘joint-death’ to try therapies such as training intervention and weight loss first. Even though this study focused on women, and it has been shown that thigh muscle status seems more important for women than men, treatment recommendations for both sexes include biomechanical interventions, exercise, self-management and education, strength training, and weight management (see for example OARSI guidelines by McAlindon et al.). However, orthopedic surgical interventions may still be needed once the more conservative treatment options have been exhausted.”