Physical Activity Is Related with Cartilage Quality in Women with Knee Osteoarthritis

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To study the relationship between 12-month leisure-time physical activity (LTPA) level and changes in estimated biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA).


Originally 87 volunteer postmenopausal women, aged 60-68 years, with mild knee OA (Kellgren Lawrence I/II and knee pain) participated in a randomised controlled, 4-month aquatic training trial (RCT), after which 76 completed the 12-month post-intervention follow-up period. Self-reported LTPA was collected along the 12-month period using a diary from which metabolic equivalent task hours (METh) per month were calculated. Participants were divided into METh tertiles: 1=lowest (n=25), 2=middle (n=25) and 3=highest (n=26). The biochemical composition of the cartilage was estimated using transverse relaxation time (T2) mapping sensitive to the properties of the collagen network and delayed gadolinium-enhanced magnetic resonance imaging of the cartilage (dGEMRIC index) sensitive to the cartilage glycosaminoglycan (GAG) content. Secondary outcomes were cardiorespiratory fitness, isometric knee extension and flexion force and the knee injury and osteoarthritis outcome questionnaire (KOOS).


During the 12-month follow-up period, there was a significant linear relationship between higher LTPA level and increased dGEMRIC index changes in the posterior region of interest (ROI) of the lateral (p=0.003 for linearity) and medial (p=0.006) femoral cartilage. Furthermore, these changes were seen in the posterior lateral femoral cartilage superficial (p=0.004) and deep (p=0.007) ROIs and in the posterior medial superficial ROI (p<0.001). There was no linear relationship between LTPA level and other measured variables.


These results suggest that higher LTPA level is related to regional increases in estimated GAG content of tibiofemoral cartilage in postmenopausal women with mild knee OA as measured with dGEMRIC index during a 12-month period.

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