The Effects of Bariatric Surgery Weight Loss on Knee Pain in Patients With Osteoarthritis of the Knee
Condition: Knee Pain; Knee Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee; Weight Loss
Study type: Observational

Summary: 
      This project is a prospective observational study that will involve the participation of 25
      volunteers that qualify for having knee osteoarthritis, are going to be having gastric bypass
      surgery and are willing to participate in this study which is designed to last up to two
      years. Potential candidates will be interviewed using a standard set of questions related to
      the study
    

Detailed description: 
      Osteoarthritis (OA) of the knee is one of the five leading causes of disability among elderly
      men and women1. According to the American Academy of Orthopedic Surgeons, an estimated 19
      million visits are made each year to physician's offices due to knee-related problems, while
      the total cost of OA was estimated at $60 billion in 2004.2

      Obesity is a primary risk factor for the development of OA among several other features such
      as age, gender, trauma, infection, heredity, and high impact sports. In the United States,
      obesity has reached epidemic proportions and experiments have shown that individuals
      clinically defined as obese with a BMI > 30.0 kg/m2 are four times more likely to have knee
      OA than those with a BMI < 25.0 kg/m2(3).

      The most common non-surgical treatment for knee OA has been the use of non-steroidal
      anti-inflammatory drugs (NSAIDs). NSAIDs work by inhibiting the cyclooxygenase (COX) enzymes
      involved in the production of pro-inflammatory molecules in the body. Although the use of
      these drugs has been shown to temporarily relieve pain and swelling associated with OA, there
      are several negative side-effects related to NSAID use including health concerns and cost.

      If chronic NSAID use for knee pain can be reduced, that would be an exceptional public health
      benefit and would decrease cost and related hospital admissions and deaths.

      This study investigates a non-surgical approach to the relief of pain associated with
      osteoarthritis in an attempt to offer a safer, less expensive alternative to other
      treatments.

      In this study we will be examining the effect of weight loss through bariatric surgery on
      Knee pain in patients with clinical criteria indicative of osteoarthritis.

      Our main objective is to determine if weight loss from bariatric surgery contributes to
      relief of knee pain and increased function in patients with osteoarthritis.

      The study will be looking at obese patients with co-morbidity of knee osteoarthritis.

      An interview will be administered and if appropriate, potential candidates will be asked a
      series of questions taken from the pain section of the Western Ontario McMaster Universities
      Index of Osteoarthritis (WOMAC). Patients with a WOMAC pain score ≥ 3 will then be asked to
      have a series of X-rays taken of their knees. Those individuals who display radiographic
      evidence of knee OA will be asked to participate in the study until the twenty five positions
      are filled. At their next pre-bariatric surgery visit, the study participants will have a
      basic knee exam performed by Kevin P. Black, M.D. in order to evaluate the structural
      integrity and alignment of the knee joint. The information gathered from the exam will serve
      as a baseline measure of knee function for the study. Prior to undergoing surgery, each of
      the 25 patients will be asked to complete a full version of the WOMAC survey and a separate,
      related survey the Knee and Osteoarthritis Outcome Score (KOOS). These surveys will be
      re-administered at 6, 12, and 24 months post-surgery in order to assess any changes in knee
      pain and function.
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The study will be looking at obese patients with co-morbidity of knee osteoarthritis.
      
Keywords: knee osteoarthritis; bariatric surgery; weight loss; knee pain