Weight Management Strategies in Knee Osteoarthritis

Weight management is a cornerstone of non-surgical care for knee osteoarthritis, with excess adiposity contributing both biomechanical overload and pro-inflammatory signalling within the joint. Therapeutic approaches encompass dietary modification, structured exercise, behavioural counselling and multi-component interventions that integrate nutrition, physical activity and psychosocial support. Dietary strategies range from hypocaloric and macronutrient-tailored plans to whole-food, anti-inflammatory regimes, each aimed at reducing body mass and adipose-derived mediators of cartilage degradation. Concurrently, progressive resistance and low-impact aerobic exercise programmes seek to improve muscle strength, joint stability and functional capacity. Emerging evidence also supports combining these elements into integrated lifestyle programmes, which can yield greater symptomatic relief and functional gains than single-component interventions. Weight loss targets of approximately 5–10% body weight have demonstrated clinically meaningful improvements in pain and mobility, while more substantial reductions may lower the risk of surgical interventions such as total knee replacement. Personalised planning, careful monitoring of nutritional adequacy and adherence support are essential to ensure both safety and long-term maintenance of weight loss, thereby optimising outcomes for individuals with knee osteoarthritis across diverse clinical settings.

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Weight Management Strategies in Knee Osteoarthritis publication trend

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Technical terms

Body mass index (BMI): A ratio of weight to height squared (kg/m2) used to classify underweight, normal, overweight and obese categories.

Osteoarthritis: A degenerative joint disease characterised by cartilage breakdown, subchondral bone changes and synovial inflammation.

Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): A standardised questionnaire assessing pain, stiffness and physical function in patients with lower-limb osteoarthritis.

Very low-calorie ketogenic diet (VLCKD): A hypocaloric dietary protocol high in fats and very low in carbohydrates designed to induce ketosis and rapid weight loss.

Total knee replacement (TKR): A surgical procedure replacing damaged knee joint surfaces with prosthetic components to relieve pain and restore function.

References

1. A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the "Plants for Joints" randomized controlled trial. Osteoarthritis and Cartilage (2023).
2. Efficacy, Safety, and Tolerability of a Very Low-Calorie Ketogenic Diet in Women with Obesity and Symptomatic Knee Osteoarthritis: A Pilot Interventional Study. Nutrients (2024).
3. Does weight loss reduce the incidence of total knee and hip replacement for osteoarthritis?—A prospective cohort study among middle-aged and older adults with overweight or obesity. International Journal of Obesity (2021).