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losing weight – ideally a weight reduction of more than 10% – and
also of maintaining the weight reduction over the following year.
Not surprisingly, the result is improved mobility and in the major-
ity also reduced pain. Based on a total score of symptoms from
the knee, a 10% weight reduction results in clinical improvement
of approx. 30%. The degree of osteoarthritis has no influence on
the scale of the weight loss or the degree of improvement achieved
from dieting, which allows us to impress on patients that bad knees
are no excuse for not losing weight.
Clearly, care has to be taken in any weight-loss plan. If patients
go on a crash diet, they risk becoming deficient in important sub-
stances, including vitamins. This may be avoided by taking dietary
products such as special powder soups to replace ordinary meals for
a period. On the Parker Institute’s programme, almost 200 partici-
pants had their poor vitamin status thoroughly rebalanced on this
form of diet (see the diet plan at www.parkerinst.dk). At the end of
the weight-loss programme, the idea is to gradually taper off the
meal replacement products in favour of an ordinary healthy diet,
and patients are recommended to seek the advice of a dietician for
this process.
An extra piece of advice on weight loss: it is not possible to lose
weight through physical exercise alone if the patient’s knees are not
up to it. There is no avoiding a change in diet, but after weight
reduction, physical exercise will be that much easier.
Basic therapy: physical exercise
Staying fit is always a good idea, and not least for people with bad
knees. If the knee osteoarthritis is still in its early stages, it appears
that people can exercise without limitation, although it has not
been finally established whether the same applies to severely af-
fected knees. Pain after physical activity is a good guide to what the
knees can cope with, and for people who are obese, it is in any event
a good idea to lose weight alongside physical exercise.
Left page: The team behind the ultrasound-based studies at the Parker Institute: Professor Bente Danneskiold-Samsøe
MD; Dr Søren Torp-Pedersen, senior research consultant, ultrasound specialist (left) and Henning Bliddal.
72 OSTEOARTHRITIS OF THE KNEE AND WEIGHT LOSS VELUX FOUNDATION 73
AGEING RESEARCH AND OPHTHALMOLOGY