Journal of Orthopaedic Case Reports · Nov 2026

Beyond Weight Loss: Effects of Semaglutide on Knee Pain, Physical Function, and Thigh Skeletal Muscle Volume in Obesity-Associated Knee Osteoarthritis

By Kumar BA, Sundaresan N, Syal A et al.

INTRODUCTION: Obesity is an important modifiable risk factor for knee osteoarthritis, contributing to pain, functional limitation, and systemic inflammation. Semaglutide may provide benefits beyond weight reduction, but its effects on clinical and functional outcomes in obesity-associated knee osteoarthritis remain insufficiently characterized. Against this background, this study sought to evaluate the effects of 6-month semaglutide treatment on weight, knee pain, physical function, thigh skeletal muscle volume, and inflammatory markers in patients with obesity-associated knee osteoarthritis. MATERIALS AND METHODS: This prospective, observational, single-arm study included 75 patients with obesity-associated knee osteoarthritis who received semaglutide and were followed for 6 months. Changes in weight, body mass index (BMI), knee pain assessed by the Visual Analogue Scale (VAS), physical function assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), thigh skeletal muscle volume, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated. RESULTS: At the 6-month follow-up, body weight decreased from 101.23 ± 15.45 to 91.47 ± 9.67 kg (mean change -9.76 kg), while BMI decreased from 34.49 ± 3.67 to 31.89 ± 5.78 kg/m2 (-2.60 kg/ m2; both P < 0.001). VAS pain scores decreased from 6.90 ± 2.10 to 4.89 ± 0.73 (-2.01; P < 0.001), and WOMAC scores improved from 59.67 ± 6.47 to 44.60 ± 6.12 (-15.07; P < 0.001). Thigh skeletal muscle volume increased from 10.6 ± 2.3 to 11.1 ± 1.8 L (+0.50 L; P < 0.001). CRP decreased from 6.14 ± 0.73 to 3.91 ± 2.08 mg/L, while ESR decreased from 27.51 ± 3.32 to 19.64 ± 4.37 mm/h. CONCLUSION: 6 months of semaglutide treatment was associated with substantial weight loss and significant improvements in knee pain and physical function, accompanied by reductions in systemic inflammatory markers. These findings suggest potential benefits of semaglutide beyond weight reduction in obesity-associated knee osteoarthritis. Larger controlled studies with longer follow-up are warranted.

doi.org/10.13107/jocr.2026.v16.i11.8546 Open access PubMed 42997011 Interventions