Association Between Joint Osteophytes and Obesity Weight-Adjusted

Abstract

This retrospective study investigated the correlation between joint osteophyte severity and obesity and evaluated weight-adjusted nursing interventions in 31 patients. Patients were categorized by BMI: normal weight (BMI <25 kg/m², n=10), overweight (25-29.9 kg/m², n=11) and obese (≥30 kg/m², n=10). Within each BMI subgroup, patients were divided into intervention (n=16) and control (n=15) groups. Intervention group received weight-tailored nursing (dietary counseling, low-impact exercise, joint protection), while controls received routine care. Primary outcomes included Lequesne Index change at 6 months and correlation between BMI and osteophyte severity. Results showed significant positive correlation between BMI and initial Lequesne Index (r=0.58, p<0.01). Intervention group demonstrated greater improvement in Lequesne Index across all BMI categories (obese: 14.2±3.8 vs 6.3±2.9; overweight: 12.5±3.2 vs 5.9±2.7; normal: 9.8±2.5 vs 4.1±2.1, p<0.01 for all). Weight-adjusted nursing effectively improves outcomes in osteophyte patients, with particular benefit in obese individuals.

Keywords: Dietary counseling; Lequesne index; Joint osteophyte severity

Introduction
Obesity is a well-established risk factor for joint osteophyte formation, with obese individuals having 2-3 times higher risk of severe osteophytes compared to normal-weight counterparts¹. Excess adiposity increases joint load (5-6 kg of force on knees per 1 kg of body weight during walking) and promotes inflammatory cytokine release, accelerating osteophyte progression². Nursing interventions addressing obesity-specific needs are understudied, highlighting the need for targeted strategies³. This study explores BMI correlations and weight-adjusted nursing efficacy in a small cohort.

Methods
Study design and participants
Retrospective analysis of 31 patients with radiographically confirmed knee/hip osteophytes (Outerbridge grade II-IV). Inclusion criteria: age 40-75 years; exclusion criteria: inflammatory arthritis, joint replacement history and metabolic disorders affecting bone metabolism.

Interventions
Control group: Routine care (pain assessment, general activity advice).

Intervention group: Weight-adjusted interventions
Calorie-restricted diet plans (1,500-1,800 kcal/day based on BMI)
Water-based exercise program (3x/week, 30 mins/session)
Joint protection education (proper lifting, footwear modification)
Monthly weight monitoring with personalized feedback

Outcome measures
• Primary: Lequesne Index (0-24) change at 6 months; BMI-osteophyte correlation.
• Secondary: VAS score, BMI reduction, joint range of motion (ROM).

Statistics
SPSS 26.0 used for Pearson correlation, ANCOVA (adjusting for baseline BMI) and post-hoc Bonferroni tests. p<0.05 was significant.

Results
BMI correlation and baseline data
Positive correlation between BMI and initial Lequesne Index (r=0.58, p<0.01). Baseline characteristics balanced between groups (Table 1).

Table 1: Baseline Characteristics by BMI Category

Primary outcome

Intervention group showed greater Lequesne Index improvement across all BMI subgroups (Table 2).

Table 2: Change in Lequesne Index at 6 Months by Group and BMI

Secondary outcomes

• Weight reduction: Intervention group achieved mean BMI reduction of 3.2±1.5 kg/m² vs 0.8±0.7 in controls (p<0.001).

• Pain and mobility: Intervention group showed lower VAS (2.8±0.9 vs 5.2±1.1) and better ROM (89.3±10.2 vs 72.5±11.3 degrees) at 6 months (p<0.001 for both).

Discussion

The significant BMI-osteophyte correlation (r=0.58) aligns with biomechanical studies showing obesity-induced joint overload accelerates osteophyte formation⁴. Weight-adjusted nursing interventions produced greater improvements, particularly in obese patients, where 3.2 kg/m² BMI reduction likely reduced joint load by 16-19 kg during ambulation⁵.

Dietary counseling combined with water-based exercise addressed dual mechanisms: reduced adiposity lowers inflammatory cytokines (IL-6, TNF-α) linked to osteophyte progression, while low-impact exercise preserves muscle strength without increasing joint stress⁶. Joint protection education minimized microtrauma, complementing weight reduction efforts⁷.

The greater absolute improvement in obese patients (14.2 vs 6.3 points in Lequesne Index) supports obesity as a modifiable risk factor responsive to targeted nursing. These findings reinforce guidelines advocating weight management as first-line therapy for obese osteoarthritis patients⁸.

Limitations include small sample size and lack of long-term radiological follow-up. Future studies should explore metabolic pathways linking adiposity and osteophyte formation.

Conclusion

Joint osteophyte severity correlates significantly with BMI. Weight-adjusted nursing interventions, combining dietary support, low-impact exercise and joint protection, effectively improve outcomes, with maximal benefit in obese patients. These findings support implementing obesity-targeted nursing protocols for this population.

References