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Extremely obese people who have a gastric band around their stomachs to restrict food intake not only lose weight but also suffer less from arthritic knee pain, a new report has found.
The extra weight they bear causes deterioration and inflammation in the knee joints, say the study leaders at New York University School of Medicine. The pain relief seen with lap-band surgery applied to all patients with osteoarthritic knees, but was most helpful in the youngest men and women who lost the most weight.
“Our study shows that extremely obese people seeking relief from their knee pain should consider lap-band surgery earlier because the benefits from it being successful – although significant for all ages – decrease with age,” says study senior investigator and rheumatologist Jonathan Samuels.
He adds it is likely that knee joints and cartilage become so damaged after a certain point that there is little cushion left for weight loss to preserve. The research team found that people in their 40s reported nearly twice as much pain relief after lap-band as those who had the surgery in their 50s.
Osteoarthritis is becoming an increasing problem in Hong Kong
More than 130,000 Americans have had the procedure done since 2011, national statistics show. Although the operation is considered relatively safe, complications may include nausea, stomach ulcers, and infection.
The study authors say their findings are especially important because one in three American adults is now overweight. (In Hong Kong, the Department of Health estimates nearly 39 per cent of the population aged 18 to 64 are overweight or obese.) Studies also show that the number of Americans with osteoarthritis has more than doubled since the second world war.
Published online in the journal Seminars in Arthritis and Rheumatism in February, the new analysis was based on the experiences of 120 patients at NYU Langone Health who had lap-band surgery between 2002 and 2015. All were surveyed about what they remembered about their knee pain immediately before surgery, a year after their procedure, and for as long as 14 years later.
The survey’s main purpose, researchers say, was to find out why some extremely obese people showed more knee-pain relief from lap-band surgery than others. Study participants had an average body mass index, or BMI, of 40, which equates to a 1.78 metre (5 ft 10 in) man weighing 127kg (280 pounds) or a 1.68 metre (5 ft 6 in) tall woman who weighs 113kg (250 pounds).
Survey results found men and women in their 40s experienced post-surgical knee pain reductions after one year of between 50 per cent and 60 per cent; those in their 50s had pain reductions one year later between 30 per cent and 40 per cent; and those in their 60s, had reductions between 20 per cent and 30 per cent. Pain relief persisted for a decade in all patients monitored.
Half of Hong-kongers over 15 now overweight or obese, damning government health study reveals
In earlier research, senior author Daniel Irimia, a surgeon at the hospital and assistant professor at Harvard Medical School, noticed that spontaneous movements of these white blood cells corresponded to the likelihood that patients would develop sepsis. Irimia and colleagues developed the hand-held device that coaxes neutrophils through a microscopic maze.
Follow-up tests with a larger, more diverse group of volunteers are under way.