J Am Acad Orthop Surg. 2013 Mar;21(3):161-9. doi: 10.5435/JAAOS-21-03-161.
A link has been established between obesity and osteoarthritis (OA), but the precise relationship has yet to be defined. OA has a multifactorial etiology, and obesity is consistently identified as an independent and modifiable risk factor. The biomechanical relationship is intuitive: increased loads on articular cartilage cause subsequent wear and cartilage breakdown. Less intuitive, and possibly more important, are the systemic effects of obesity on OA. Promising investigations into relationships between lipid metabolism and OA have been rarely reported in the orthopaedic literature. These reports argue that, in obese patients, weight loss may not only help prevent OA but also may be an effective treatment strategy. Orthopaedic surgeons should be aware of the biomechanical and systemic implications of obesity with respect to OA so that patients may be counseled accordingly.
肥胖症与骨关节炎（OA）之间存在关联，但确切的关系尚未确定。OA 具有多因素病因，肥胖症被一致认为是一个独立且可改变的危险因素。这种生物力学关系是直观的：关节软骨承受的负荷增加会导致随后的磨损和软骨破坏。不太直观但可能更重要的是肥胖症对 OA 的全身影响。脂质代谢与 OA 之间的关系的研究在骨科文献中很少有报道。这些报告认为，在肥胖患者中，减肥不仅有助于预防 OA，而且可能是一种有效的治疗策略。骨科医生应该了解肥胖症对 OA 的生物力学和全身影响，以便对患者进行相应的咨询。
