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Impact of BMI on Knee Osteoarthritis WOMAC Severity in Adults: A Cross-Sectional Study

Authors

  • Arya Satya Rajanagara

    CHINA MEDICAL UNIVERSITY
  • Basra Ahmad Amru

    Universitas Pembangunan Nasional Veteran Jakarta
  • Aditya Putra

    School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia
  • Hafidz Naeriansyah Djajawiguna

    Universitas Pembangunan Nasional Veteran Jakarta
  • Mohammad Alief Iqra

    Universitas Gadjah Mada
  • Syifa Shafira

    Faculty of Medicine, Jenderal Achmad Yani University, Bandung
  • ⁠I Putu Wirasatya Eka Putra

    Faculty of Medicine and Health Sciences, Warmadewa University
  • Dhea JRN Mangun

    Faculty of Medicine, Trisakti University, Jakarta

DOI:

https://doi.org/10.53366/jimki.v12i2.992

Keywords:

Osteoarthritis, Degenerative joint disease, WOMAC, Body Mass Index, knee pain

Abstract

Background: Knee osteoarthritis (OA) is a degenerative joint disease that most often causes pain and disability in adults and the elderly. Risk factors for OA progression include age, gender, physical activity, and body mass index (BMI). Increased BMI is known to contribute to increased mechanical load on the knee joint and trigger inflammation, which can exacerbate OA severity.

Objective: To assess the relationship between body mass index (BMI) and the severity of knee osteoarthritis in adult patients.

Methods: This is a cross-sectional analytical study conducted at Rheumatology Clinic of Dr. Soetomo General Hospital, Surabaya, in 2019. A total of 42 patients diagnosed with knee OA who met the inclusion and exclusion criteria were enrolled. OA severity was assessed using the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score, while BMI was calculated based on WHO standards and categorized into normal and high (overweight/obese). Analysis of the relationship between BMI and the severity of OA was carried out using the Fisher's Exact Test, with a p value < 0.05 considered significant.

Results: Most patients with normal BMI had moderate-severe OA (77.8%), while patients with high BMI were more likely to have very severe OA (58.3%). Fisher's Exact Test showed a significant association between BMI and OA severity (p = 0.0285). Patients with high BMI were more likely to have very severe OA compared to patients with normal BMI (OR ? 4.9; 95% CI ? 1.1–21.5).

Conclusion: There was a significant association between increasing BMI and the severity of knee osteoarthritis. These findings emphasize the importance of weight control as part of the prevention and management strategy for knee OA in adult patients.

References

1. GBD 2021 Osteoarthritis Collaborators. Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatology. 2023;5(9):e543–e555.

2. Pavel, R. M. S., Purza, A. L., Tit, D. M., Radu, A.-F., Iovanovici, D. C., Vasileva, D., Uivarășeanu, B., Bungău, G., & Nistor-Cseppento, C. D. (2025). Functional burden and quality of life in hip and knee osteoarthritis: A cross-sectional study. Medicina, 61(7), 1155. https://doi.org/10.3390/medicina6101155

3. Gersing, A. S., Schwaiger, B. J., Nevitt, M. C., Lynch, J. A., McCulloch, C. E., Lane, N. E., Link, T. M., & Crema, M. D. (2017). Is weight loss associated with less progression of changes in knee articular cartilage among overweight and obese patients? Radiology, 284(2), 508–520. https://doi.org/10.1148/radiol.2017161161

4. Seifeldein, G. S., Haseib, A., Hassan, H. A., & Ahmed, G. (2019). Correlation of knee ultrasonography and Western Ontario and McMaster University (WOMAC) osteoarthritis index in primary knee osteoarthritis. Egyptian Journal of Radiology and Nuclear Medicine, 50(1), 1–7. https://doi.org/10.1186/s43055-019-0029-4

5. Brkic, S., Gilic, B., Obradovic Salcin, L., Ostojic, D., Ostojic, L., Miljanovic Damjanovic, V., Geets Kesic, M., Simic, J., & Sekulic, D. (2025). Analysing the association of BMI, physical activity and sociodemographics with osteoarthritis symptom severity: Cross-sectional study in Southern Bosnia and Herzegovina. BMJ Open, 15(9), e092849. https://doi.org/10.1136/bmjopen-2024-092849

6. Raud, B., Gay, C., Guiguet-Auclair, C., et al. (2020). Level of obesity is directly associated with the clinical and functional consequences of knee osteoarthritis. Scientific Reports, 10(1), 3601. https://doi.org/10.1038/s41598-020-60587-1

7. Devi, N., Alamsyah, S., Setiawan, I., & Ichsan, B. (2024). Relationship between body mass index (BMI), stage of knee osteoarthritis, and pain severity. Journal of Health Studies (JHeS), 8, 63–72. https://doi.org/10.31101/jhes.3543

8. Shumnalieva, R., Kotov, G., & Monov, S. (2023). Obesity-related knee osteoarthritis—Current concepts. Life, 13(8), 1650. https://doi.org/10.3390/life13081650

9. Logerstedt, D. S., Ebert, J. R., MacLeod, T. D., Heiderscheit, B. C., Gabbett, T. J., & Eckenrode, B. J. (2022). Effects of and response to mechanical loading on the knee. Sports Medicine, 52(2), 201–235. https://doi.org/10.1007/s40279-021-01579-7

10. Biomechanics and pathomechanisms of osteoarthritis (2012). Swiss Medical Weekly, 142(2930), w13583. https://smw.ch/index.php/smw/article/view/1523

11. Primorac, D., Molnar, V., Rod, E., Jeleč, Ž., Čukelj, F., Matišić, V., Vrdoljak, T., Hudetz, D., Hajsok, H., & Borić, I. (2020). Knee osteoarthritis: A review of pathogenesis and state-of-the-art non-operative therapeutic considerations. Genes, 11(8), 854. https://doi.org/10.3390/genes11080854

12. Urban, H., & Little, C. B. (2018). The role of fat and inflammation in the pathogenesis and management of osteoarthritis. Rheumatology, 57(suppl_4), iv10–iv21. https://doi.org/10.1093/rheumatology/kex39

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Published

2026-01-15

How to Cite

Impact of BMI on Knee Osteoarthritis WOMAC Severity in Adults: A Cross-Sectional Study. (2026). JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia, 12(2). https://doi.org/10.53366/jimki.v12i2.992