Presenter’s name (Last, First): Wilcox, Ben

Qualifications: BMed, MD

Affiliations: John Hunter Hospital (HNELHD), Newcastle

Other authors:
Associate Professor David Dewar, MBBS(HONS), B.MED SCI, FRACS, FAORTHOA, PHD, John Hunter Hospital (HNELHD), Newcastle.Elysse McIlwain, MD, John Hunter Hospital (HNELHD), Newcastle. Luke Lawler, BSc, Prima Health Solutions. Dr Ryan Gallagher, PhD, Honeysuckle Health. Gareth Williams, B Teaching/B Health &Physical Education, Honeysuckle Health

Email: ben.wilcox1@hotmail.com

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Background / Introduction:
Osteoarthritis is a huge source of morbidity in Australia and around the world. According to the Australia Orthopaedic Association National Joint Replacement Registry, the majority of patients undergoing total knee arthroplasty are obese. Weight loss serves to improve pain and function in patients with knee osteoarthritis. This study aims to examine the effect of the Osteoarthritis Healthy Weight For Life (OAHWFL) program on pain, particularly in those patients with a high starting level of pain.

Patients / Methods:

Patients with a BMI ≥28 and symptomatic knee osteoarthritis were enrolled into the OAHWFL program following recommendation by a medial professional. OAHWFL consists of a diet and exercise program, along with education and multi-disciplinary psychosocial support. Pre and post-program data was recorded for all patients, including weight and Knee injury and Osteoarthritis Outcome Score (KOOS). Data was then analysed to determine whether starting knee pain (KOOS) affected the change in pain produced by weight loss.

Results:

In total, 6360 patient data points were analysed. Patients with a starting KOOS of 75 or lower had an improvement in their KOOS during the program. Patients whose initial KOOS was 75 or higher did not reach the threshold for a meaningful improvement. When patients were stratified into high pain (KOOS 50) scores, any weight loss produces a meaningful change in the high pain (low KOOS) group, whilst >7.5% bodyweight loss is required to produce this in the low pain (high KOOS) group.

Conclusion:
Patients with worse knee pain see more improvement in KOOS upon completion of the OAHWFL program compared to those with more mild symptoms. This important message can be provided to patients, especially when those who believe their pain is too debilitating to benefit from weight loss and exercise programs.

Level of Evidence & Study type: 3 Retrospective Audit

Declarations of Conflict: Luke Lawler is the CEO of Prima Health Solutions (Prima) which is a fully owned subsidiary of Honeysuckle Health. Prima delivers the Healthy Weight for Life program. Dr Ryan Gallagher is a Clinical Insights Analyst employed by Honeysuckle Health. Gareth Williams is a Medical Specialist Relationship Manager employed by Honeysuckle Health.