This study compared body composition between patients with early knee osteoarthritis (EKOA) and late knee osteoarthritis (LKOA). 110 patients were evaluated, 56 with EKOA and 54 with LKOA, matched by gender. Patients with LKOA had significantly less total lean mass, lean mass index, and appendicular lean mass in both knees compared to those with EKOA. They also had higher levels of total body fat and body fat index. Patients with LKOA reported worse pain, stiffness, physical function, total WOMAC scores, EQ-5D scores, and Lequesne scores compared to those with EKOA. The results suggest that body composition differs between early and late stages of

1. Introduction:
 KOA affects cartilage, periarticular and and synovial tissue.
 Obesity: Risk factor for genesis and KOA progression, and future
totak knee arthroplasty (TKA) muscle mass (lean mass) protects
against KOA progression.
 Differences between body composition parameters in early
(EKOA) or advanced stages KOA not found in Medical literature
 Implications of body composition in EKOA vs LKOA in PROs pre
and post TKA is a subject required to be explored.
Methods:
 Patients recruited from primary and tertiary hospital care.
 Inclusion criteria EKOA group:
 KOA ACR Classification criteria, Men and women <55 y.o.
Kellgren-Lawrence I or II.
 Inclusion criteria LKOA group:
 KOA ACR Classification criteria, Men and women of any age,
Kellgren-Lawrence III-IV,fullfilling AAOS criteria for one or
both knee total arthroplasty.
 Exclusion criteria for both groups:
 Patients with any secondary cause for KOA.
 Patients with fibromyalgia or any previously autoimmune
diasease.
 Both groups received same baseline evaluations: Full
clinimetry, standarized protocol for multifrequency
bioimpedance body composition assesment (InBody 720®);
demographic, epidemiologic, quality of life, knee pain and
functionality questionares.
 Analysis. Bivariate analysis using appropriate to compare
median between EKOA vs LKO patients.
Results:
 110 patients evaluated (56 EKOA/54 LKOA) paired by gender.
 Proportion of women(71.8%) vs men (28.2%) was superior for
female group.
 EKAO yonger than LKOA median 48.5 vs 65.5 y.o respectively
 Comparisons between body composition and PROs shown on
table
DIFFERENCE IN BODY COMPOSITION BETWEEN PATIENTS WITH EARLY KNEE
OSTEOARTHRITIS (KOA), COMPARED TO LATE KNEE OA IN A MEXICAN POPULATION
VALERIO-MORALES IA1, SANCHEZ A, HERNÁNDEZ A, PABELTO P, EVIA A, ILIZALITURRI V, ESPINOSA R.
INSTITUTO NACIONAL DE REHABILITACIÓN/UNIVERSIDAD NACIONAL AUTÓNOMA DE MÉXICO
Comparison EKOA vs LKOA body composition
Variable EKOA LKOA p value
BMI (kg/m2) Women
Men
29.8 (22.2-45.6)
28.3 (24.3-40.1)
30.4 (20.2-42.9)
29.3 (23.1-38)
0.43
0.58
Total lean mass (kg)
Women
Men
35 (18-36)
27.6 (19-38.5)
20.8 (13.4 – 26.6)
27.9 (21.5 – 41.3)
0.001
0.71
Lean mass index(kg/m
2
)
Women
Men
9.9 (8.1-12.8)
10.2 (8.4-13.3)
8.8 (7.1-10.8)
10.1(8.5-12.6)
0.001
0.71
Total body fat (kg)* Women
Men
28.4(14-60)
26(13-48)
32.5(14.4-52.2)
27.1(13.8-45.3)
0.14
0.71
Body fat index* (kg/m
2
) Women
Men
11.2 (4.7-24.3)
10.2(5-17.8)
14.2(6.2-23.4)
10.2(5.7-16.8)
0.005
0.71
Appendicular lean mass in
right symptomatic knee (kg)
Women
Men
6.57 (4.84-9.81)
7.28(5.31-8.64)
5.1(2.44-7.63)
7.65(6.08-10-76)
0.009
0.508
Appendicular lean mass in
left symptomatic knee (kg)
Women
Men
6.44(4.59-8.75)
7.39(6.95-10.41)
5.12(4.07-7.12)
7.45(5.77-8.33)
0.008
0.819
WOMAC (Domains)
Pain*
Stiffness*
Physical^
Tota^
7 (0-20)
2.7 (1.70)
22.3(12.8)
31.6(16.8)
9 (1-18)
3.1 (1.66)
32.9(11.3)
44.9(15.01)
0.008⌘
0.1471§
0.001§
0.001§
EuroQol* 0.493 (0.1748-0.7902) 0.5942 (0.1703-1) 0.018¶
Lequesne^ 13.8 (3.6) 8.6(3.59) 0.001§
*Median (Rank) , ^Mean (SD) ,§ T-Test ,¶ Mann-Whitney, ⌘ Pearson-Chi
Conclusions:
 Differences found only in female gender groups comparisons.
 LKOA group had less total lean mass, lean mass index and more
total body fat.
 Apendix (Extremity) more affected showed less lean mass in LKOA
vs EKOA.
 Funtionality, pain and quality of life is more detrimented by KOA
with remark on late knee osteoarthritis.
 Baseline body composition assesment may predict outcomes in
TKA.
References:
Sowers, M. F. et al. BMI vs body composition and radiographically defined osteoarthritis of the knee in women: a 4-year
follow-up study. Osteoarthritis Cartilage 16, 367–372 (2008). Sharma, L., Dunlop, D. D., Cahue, S., Song, J. & Hayes, K. W.
Quadriceps strength and osteoarthritis progression in malaligned and lax knees. Ann. Intern. Med. 138, 613–619 (2003). Lee,
S., Kim, T.-N. and Kim, S.-H. (2012), Sarcopenic obesity is more closely associated with knee osteoarthritis than is
nonsarcopenic obesity: A cross-sectional study. Arthritis & Rheumatism, 64: 3947–3954. doi: 10.1002/art.37696. Percent
Body Fat More Associated with Perioperative Risks After Total Joint Arthroplasty Than Body Mass Index. Ledford, Cameron K.
et al. The Journal of Arthroplasty , Volume 29 , Issue 9 , 150 – 154
Funding by CONACYT grant SALUD-2009-01-115275