Research Summary

Intentional weight loss for overweight and obese knee osteoarthritis patients: Is more better?

Messier, S.P., Resnik, A.E., Beavers, D.P., Mihalko, S.L., Miller, G.D., Nicklas, B.J., DeVita, P., Hunter, D.J., Lyles, M.F., Eckstein, F., Guermazi, A., and Loeser, R. F. (2018) Arthritis Care Res. (Hobokin). 70(11): 1569–1575.

Key Findings


Greater amounts of weight loss (over 10%) resulted in greater clinical and mechanistic outcomes.



Evidence suggests minimum 10% weight loss as standard of care for older, overweight or obese adults with knee OA.


Weight loss resulted in improvements across multiple measures, including pain, function, and quality of life.

A secondary analysis of two diet groups from a randomized clinical trial (Intensive Diet and Exercise for Arthritis) was conducted to determine dose responses to weight loss in obese and overweight participants with knee osteoarthritis (OA). After 18 months of weight loss, participants were divided into groups based on their achieved weight loss (below 5%, 5–10%, 10–20%, and over 20%). Participants were then evaluated for clinical and mechanistic outcomes including pain, function, physical and mental quality of life (HRQL), and knee joint compressive force.

Weight loss resulted in significant dose responses for pain, function, HRQL, knee joint compressive force, and other measured outcomes. Participants who achieved more weight loss had greater improvements in the measures, with the over 20% group reporting 25% less pain and better function than the 10–20% group. However, the study was limited by the small sample size in the over 20% weight loss group. Researchers concluded that older, overweight and obese adults with knee OA should lose at least 10% of their weight to experience clinically meaningful improvements in wellbeing.

Relevance to Spring Loaded Braces

For overweight and obese patients with OA, this study demonstrates weight loss as an effective intervention resulting in improvements to multiple clinical and mechanistic measures. However, as this study also notes, achieving and maintaining weight loss can be challenging for patients for a variety of reasons, including slowed metabolic rate and feelings of starvation.

As a tri-compartment offloader with a powerful leg extension assist, a Spring Loaded brace may serve as a viable alternative to weight loss or valuable support for sustained weight loss efforts. Proven to reduce joint loads equivalent to 45 lb of weight loss 1– Budarick, A.R. et al. (2020). J. Biomech. Eng. 142(1), Spring Loaded bracing may provide patients with outcomes similar to weight loss or enable them to achieve additional weight loss through improvements to their levels of knee pain, function, and physical activity levels 2– Budarick, A.R. et al. (2020) J. Prosthet. Orthot. Under Peer Review..

Multiple Forces Reduced

Each TCO brace model significantly reduced PF, TF, PC ligament, PT and QT forces during a deep knee bend test.

Reduced Joint Load

Each TCO brace model significantly reduced knee joint loads by at least 32% when compared to the non-braced condition.

Replicates & Extends Previous Research

Results corroborate the knee joint offloading capabilities of a TCO, as demonstrated in a previous study (Budarick et al. 2020).

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