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The effect of weight loss on the progression of meniscal extrusion and size in knee osteoarthritis: a post-hoc analysis of the Intensive Diet and Exercise for Arthritis (IDEA) trial

journal contribution
posted on 2023-05-20, 14:01 authored by Ishanka MunugodaIshanka Munugoda, Beavers, DP, Wirth, W, Dawn AitkenDawn Aitken, Loeser, RF, Miller, GD, Lyles, M, Carr, JJ, Guermazi, A, Hunter, DJ, Messier, SP, Eckstein, F
Objective: Weight loss has beneficial effects on clinical outcomes in knee osteoarthritis (OA), but the mechanism is still unclear. Since meniscus extrusion is associated with knee pain, this study assessed whether weight loss by diet and/or exercise is associated with less progression in meniscus extrusion measures over time.

Design: The Intensive Diet and Exercise for Arthritis trial (IDEA) was a prospective, single-blind, randomized-controlled trial including overweight and obese older adults with knee pain and radiographic OA. Participants were randomized to 18-month interventions: exercise only, diet only or diet + exercise. In a random subsample of 105 participants, MRIs were obtained at baseline and follow-up. The medial and lateral menisci were segmented and quantitative position and size measures were obtained, along with semiquantitative extrusion measures. Linear and log-binomial regression were used to examine the association between change in weight and change in meniscus measures. Between-group differences were analyzed using an analysis of covariance.

Results: Weight loss was associated with less progression over time of medial meniscus extrusion as measured by the maximum (β: -24.59 μm, 95%CI: -41.86, -7.33) and mean (β: -19.08 μm, 95%CI: -36.47, -1.70) extrusion distances. No relationships with weight loss were observed for lateral meniscus position, medial or lateral meniscus size or semiquantitative measures. Change in meniscus position and size did not differ significantly between groups.

Conclusions: Weight loss was associated with beneficial modifications of medial meniscus extrusion over 18 months. This may be one of the mechanisms by which weight loss translates into a clinical benefit.


Publication title

Osteoarthritis and Cartilage










Menzies Institute for Medical Research


W B Saunders Co Ltd

Place of publication

32 Jamestown Rd, London, England, Nw1 7By

Rights statement

Copyright 2020 Osteoarthritis Research Society International

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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