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- W2976604562 abstract "Objective Massive weight loss leads to marked knee pain reduction in individuals with knee pain, but the reason for the reduction in pain is unknown. This study was undertaken to quantify the contribution of magnetic resonance imaging ( MRI )–evidenced changes in pain‐sensitive structures, bone marrow lesions ( BML s), and synovitis, and changes in pain sensitization or depressive symptoms, to knee pain improvement after substantial weight loss. Methods Morbidly obese patients with knee pain on most days were evaluated before bariatric surgery or medical weight management and at 1‐year follow‐up for BML s and synovitis seen on MRI , the pressure pain threshold ( PPT ) at the patella and the right wrist, depressive symptoms (using the Center for Epidemiologic Studies Depression scale [ CES ‐D]), and Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) pain survey. Natural‐effects models were used to quantify the extent that achieving a minimum clinically important difference ( MCID ) of ≥18% on the WOMAC pain scale could be mediated by weight loss–induced changes in BML s, synovitis, PPT , and depressive symptoms. Results Of 75 participants, 53.3% lost ≥20% of weight by 1 year. Of these, 75% attained the MCID for pain improvement, compared with 34.3% in those who had <20% weight loss. Mediation analyses suggested that, in those with at least 20% weight loss, the odds of pain improvement increased by 62%, 15%, and 22% through changes in patella PPT , wrist PPT , and CES ‐D, respectively, but pain improvement was not mediated by MRI changes in BML s or synovitis. Conclusion Weight loss–induced knee pain improvement is partially mediated by changes in pain sensitization and depressive symptoms but is independent of MRI changes in BML s and synovitis." @default.
- W2976604562 created "2019-10-03" @default.
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- W2976604562 date "2020-01-22" @default.
- W2976604562 modified "2023-10-15" @default.
- W2976604562 title "Mediating Role of Bone Marrow Lesions, Synovitis, Pain Sensitization, and Depressive Symptoms on Knee Pain Improvement Following Substantial Weight Loss" @default.
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- W2976604562 doi "https://doi.org/10.1002/art.41125" @default.
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