title: Cartilage defects are associated with physical disability in obese adults.
abstract: OBJECTIVE
  To describe the associations between physical disability measures and knee cartilage defects in obese adults.
  
  
  METHODS
  One hundred and eleven obese subjects were recruited from laparoscopic adjustable gastric banding or exercise/diet weight loss programmes. All subjects completed disease-specific (WOMAC) and general health status (SF-36) questionnaires, and were assessed for range of knee motion, tibiofemoral alignment and quadriceps strength. Knee cartilage defects were graded on MRI according to established protocol. Regression analysis was adjusted for age, gender, BMI and presence of clinical knee OA.
  
  
  RESULTS
  The association between higher whole compartment cartilage defect scores and increasing BMI, age and clinical knee OA was confirmed in this obese cohort (r = 0.27, P = 0.01; r = 0.26, P = 0.007; P < 0.0001, respectively), whereas new associations were found with reduced knee range of motion (r = 0.5, P < 0.0001). No associations were found between defect scores and quadriceps strength. Varus malalignment was associated with higher medial cartilage defect scores (r = 0.33, P = 0.013). Higher levels of pain, stiffness and physical disability (WOMAC, SF-36) were associated with higher medial compartment and patella cartilage defect scores.
  
  
  CONCLUSIONS
  Knee cartilage defects increase with increasing obesity and are associated with both objective and self-reported measures of physical disability. Longitudinal studies are required to assess the potential for change or improvement in cartilage defects with weight loss.
authors.affiliation: Department of Rheumatology, Institute of Bone and Joint Research, Kolling Institute, Sydney, NSW 2065, Australia.
authors.forename: Ananthila
authors.initials: A
authors.lastname: Anandacoomarasamy
authors.forename: Garett
authors.initials: G
authors.lastname: Smith
authors.forename: Steven
authors.initials: S
authors.lastname: Leibman
authors.forename: Ian
authors.initials: I
authors.lastname: Caterson
authors.forename: Bruno
authors.initials: B
authors.lastname: Giuffre
authors.forename: Marlene
authors.initials: M
authors.lastname: Fransen
authors.forename: Philip
authors.initials: P
authors.lastname: Sambrook
authors.forename: Lyn
authors.initials: L
authors.lastname: March
mesh_terms: D000328:Adult; D002357:Cartilage Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D002358:Cartilage, Articular / Q000473:pathology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D009765:Obesity / Q000150:complications*; D020370:Osteoarthritis, Knee / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D016059:Range of Motion, Articular; D012720:Severity of Illness Index