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Assessing the impact of bariatrics on osteoarthritis progression

Published:February 10, 2023DOI:https://doi.org/10.1016/j.joca.2023.02.002
      The link between obesity and lower extremity osteoarthritis (OA) comes as no surprise, as excess weight places increased biomechanical demands on articular cartilage and other joint structures. Studies suggest that obesity also exacerbates pain from OA pain via adipokine and inflammatory-mediated cascades, beyond the mechanical load effects
      • Richette P.
      • Poitou C.
      • Garnero P.
      • Vicaut E.
      • Bouillot J.L.
      • Lacorte J.M.
      • et al.
      Benefits of massive weight loss on symptoms, systemic inflammation and cartilage turnover in obese patients with knee osteoarthritis.
      . While there might be a causative relationship between chronic pain and obesity, it is believed to be multifactorial. Obesity has long been touted as the most modifiable risk factor in OA pathogenesis, given the options to lose weight through diet, exercise and/or surgery, even though studies have yet to demonstrate structural preservation from weight loss surgery
      • Jafarzadeh S.R.
      • Clancy M.
      • Li J.S.
      • Apovian C.M.
      • Guermazi A.
      • Eckstein F.
      • et al.
      Changes in the structural features of osteoarthritis in a year of weight loss.
      .
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