Review: moderate weight loss reduces functional disability but does not reduce pain in obese patients with knee osteoarthritis

摘要

QUESTIONIn obese patients with knee osteoarthritis (OA), does weight loss reduce pain and improve functional disability?METHODSData sources: MEDLINE (1966 to April 2006), EMBASE/ Excerpta Medica (1980 to April 2006), CINAHL (1982 to April 2006), Web of Science (1945 to April 2006), Scopus (1966 to May 2006), Cochrane Musculoskeletal Group's trials register, Cochrane Central Register of Controlled Trials, conference abstracts, and reference lists.Study selection and assessment: randomised controlled trials (RCTs) that evaluated any intervention reporting weight change as the only difference between the treatment and control groups in obese patients with knee OA. Concomitant treatments (eg, medication, exercise, or behavioural therapy) had to be identical in treatment and control groups. In studies of mixed patient populations (eg, hip and knee OA), only patients with knee OA were included. Quality assessment of individual studies was based on the 5-point Jadad scale. 4 RCTs (mean age range 63-69 y) met the selection criteria and had Jadad scores of 2 or 3. The interventions evaluated included combinations of a lowenergy diet (3.4 MJ/d); nutrition classes; cognitive behavioural therapy; and mazindol, an anorexigenic sympathomimetic drug, 0.5 mg/day.Outcomes: pain, self-reported disability, and patient global evaluation (Lequesne index).