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Monte A, Franchi MV, Zamparo P. Characterization of the in vivo transient responses of the femoral cartilage by means of quantitative ultrasound imaging techniques. Scand J Med Sci Sports 2024; 34:e14613. [PMID: 38534068 DOI: 10.1111/sms.14613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/25/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Quantitative ultrasound (QUS) techniques are new diagnostic tools able to identify changes in structural and material properties of the investigated tissue. For the first time, we evaluated the capability of QUS techniques in determining the in vivo transient changes in knee joint cartilage after a stressful task. METHODS An ultrasound scanner collecting B-mode and radiofrequency data simultaneously was used to collect data from the femoral cartilage of the right knee in 15 participants. Cartilage thickness (CTK), ultrasound roughness index (URI), average magnitude ratio (AMR), and Nakagami parameters (NA) were evaluated before, immediately after and every 5 min up to 45 min a stressful task (30 min of running on a treadmill with a negative slope of 5%). RESULTS CTK was affected by time (main effect: p < 0.001). Post hoc test showed significant differences with CTK at rest, which were observed up to 30 min after the run. AMR and NA were affected by time (p < 0.01 for both variables), while URI was unaffected by it. For AMR, post hoc test showed significant differences with rest values in the first 35 min of recovery, while NA was increased compared to rest values in all time points. CONCLUSION Data suggest that a single running trial is not able to modify the integrity of the femoral cartilage, as reported by URI data. In vivo evaluation of QUS parameters of the femoral cartilage (NA, AMR, and URI) are able to characterize changes in cartilage properties over time.
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Affiliation(s)
- Andrea Monte
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Paola Zamparo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Watkins LE, Goyal A, Gatti AA, Kogan F. Imaging of joint response to exercise with MRI and PET. Skeletal Radiol 2023; 52:2159-2183. [PMID: 36646851 PMCID: PMC10350475 DOI: 10.1007/s00256-022-04271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 01/18/2023]
Abstract
Imaging of the joint in response to loading stress may provide additional measures of joint structure and function beyond conventional, static imaging studies. Exercise such as running, stair climbing, and squatting allows evaluation of the joint response to larger loading forces than during weight bearing. Quantitative MRI (qMRI) may assess properties of cartilage and meniscus hydration and organization in vivo that have been investigated to assess the functional response of these tissues to physiological stress. [18F]sodium fluoride ([18F]NaF) interrogates areas of newly mineralizing bone and provides an opportunity to study bone physiology, including perfusion and mineralization rate, as a measure of joint loading stress. In this review article, methods utilizing quantitative MRI, PET, and hybrid PET-MRI systems for assessment of the joint response to loading from exercise in vivo are examined. Both methodology and results of various studies performed are outlined and discussed. Lastly, the technical considerations, challenges, and future opportunities for these approaches are addressed.
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Affiliation(s)
| | - Ananya Goyal
- Department of Radiology, Stanford University, 1201 Welch Rd, Stanford, CA, 94305, USA
| | - Anthony A Gatti
- Department of Radiology, Stanford University, 1201 Welch Rd, Stanford, CA, 94305, USA
| | - Feliks Kogan
- Department of Radiology, Stanford University, 1201 Welch Rd, Stanford, CA, 94305, USA.
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3
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Shu D, Chen F, Guo W, Ding J, Dai S. Acute changes in knee cartilage and meniscus following long-distance running in habituate runners: a systematic review on studies using quantitative magnetic resonance imaging. Skeletal Radiol 2022; 51:1333-1345. [PMID: 34854970 DOI: 10.1007/s00256-021-03943-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Running is among the most popular recreational activities; nonetheless, the acute post-race changes of cartilage or meniscus have rarely been determined. The current study aimed to review the acute changes in knee cartilage and meniscus among habituate runners following long-distance running detected by using quantitative magnetic resonance imaging (MRI). MATERIALS AND METHODS Systematic literature search was performed on those dominate clinical databases which including MEDLINE, Cochrane, Embase, ScienceDirect, and Web of Science. Included studies should be conducted on healthy marathon runners, and the participants should be examined before and after running by using MRI. Intervention studies were excluded. RESULTS A total number of 14 studies were finally included in this review which all examined the cartilage or meniscus by using MRI functional sequences. Among them, six studies quantitatively measured the changes regarding volume of the knee cartilage or/and meniscus. Five studies found that the volume would decrease initially after running. Ten studies reported T2 (T2*) would decrease after running and returned to the baseline in a short term, while T1ρ may remain increased in months. Five studies measured subareas for T2 (T2*) value, and found that the superficial and medial subarea changed more vastly than other regions after running. CONCLUSION Runners experience transient changes in the volume and signals of knee cartilage and meniscus after long-distance running. A liquid exchange and material interaction in cartilage and meniscus was observed after running. Superficial and medial areas of knee cartilage and meniscus might be more susceptible to mechanical loading.
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Affiliation(s)
- Dingbo Shu
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Feng Chen
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Wentong Guo
- Department of Computer Science, City University of Hong Kong, Hong Kong, China
| | - Jianping Ding
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Siyu Dai
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China.
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
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4
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T2*-Mapping of Knee Cartilage in Response to Mechanical Loading in Alpine Skiing: A Feasibility Study. Diagnostics (Basel) 2022; 12:diagnostics12061391. [PMID: 35741201 PMCID: PMC9222057 DOI: 10.3390/diagnostics12061391] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 12/10/2022] Open
Abstract
Purpose: This study intends to establish a study protocol for the quantitative magnetic resonance imaging (qMRI) measurement of biochemical changes in knee cartilage induced by mechanical stress during alpine skiing with the implementation of new spring-loaded ski binding. Methods: The MRI-knee-scans (T2*-mapping) of four skiers using a conventional and a spring-loaded ski binding system, alternately, were acquired before and after 1 h/4 h of exposure to alpine skiing. Intrachondral T2* analysis on 60 defined regions of interest in the femorotibial knee joint (FTJ) was conducted. Intra- and interobserver variability and relative changes in the cartilage T2* signal and thickness were calculated. Results: A relevant decrease in the T2* time after 4 h of alpine skiing could be detected at the majority of measurement times. After overnight recovery, the T2* time increased above baseline. Although, the total T2* signal in the superficial cartilage layers was higher than that in the lower ones, no differences between the layers in the T2* changes could be detected. The central and posterior cartilage zones of the FTJ responded with a stronger T2* alteration than the anterior zones. Conclusions: For the first time, a quantitative MRI study setting could be established to detect early knee cartilage reaction due to alpine skiing. Relevant changes in the T2* time and thus in the intrachondral collagen microstructure and the free water content were observed.
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5
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Lindner D, Chechik Y, Beer Y, Tal S, Lysyy O, Blumenfeld-Katzir T, Ben-Eliezer N, Agar G. T2 Mapping Values in Postmeniscectomy Knee Articular Cartilage after Running: Early Signs of Osteoarthritis? J Knee Surg 2022; 35:739-749. [PMID: 33111272 DOI: 10.1055/s-0040-1718596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Loading on the joints during running may have a deleterious effect on post-partial meniscectomy knee cartilage, leading to osteoarthritis. Utilizing T2-mapping measurements before and after running may enable the observation of changes in the articular cartilage of the postmeniscectomy knees compared with healthy knees. After medial partial meniscectomy, 12 volunteers underwent magnetic resonance imaging (MRI) of the both knees, before and immediately after 30 minutes of running. Quantitative assessment of articular cartilage was performed using a T2-mapping technique. In the medial compartment of the operated knees, significantly lower T2 values were found in anterior tibial plateau (pre- vs. postrun: 33.85 vs. 30.45 ms; p = 0.003) and central tibial plateau (33.33 vs. 30.63 ms; p = 0.007). Similar differences were found in lateral regions of central femur (post- vs. prerun: 35.86 vs. 40.35 ms; p = 0.015), posterior femur (34.89 vs. 37.73 ms; p = 0.001), and anterior tibia (24.66 vs. 28.70 ms, p = 0.0004). In lateral compartment, postrun values were significantly lower in operated compared with healthy knees, in central femur (34.89 vs. 37.59 ms; p = 0.043), posterior femoral (36.88 vs. 39.36 ms; p = 0.017), anterior tibia (24.66 vs. 30.20 ms; p = 0.009), and posterior tibia (28.84 vs. 33.17 ms; p = 0.006). No statistical difference was found while comparing postrun to prerun healthy knees. Lower T2 values were found in operated knees after 30 minutes of running. These changes were seen in medial and lateral compartments. We suspect that running may subject the articular cartilage to excessive loads in the post-partial meniscectomy knee, loads that in healthy knee do not cause any changes.
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Affiliation(s)
- Dror Lindner
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yigal Chechik
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yiftah Beer
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Tal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Radiology, Shamir Medical Center, Zerifin, Israel
| | - Oleg Lysyy
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Radiology, Shamir Medical Center, Zerifin, Israel
| | | | - Noam Ben-Eliezer
- Department of Biomedical Engineering, Tel-Aviv University, Tel Aviv, Israel
| | - Gabriel Agar
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Schenk H, Simon D, Waldenmeier L, Evers C, Janka R, Welsch GH, Pachowsky ML. Regions at Risk in the Knee Joint of Young Professional Soccer Players: Longitudinal Evaluation of Early Cartilage Degeneration by Quantitative T2 Mapping in 3 T MRI. Cartilage 2021; 13:595S-603S. [PMID: 32449383 PMCID: PMC8808898 DOI: 10.1177/1947603520924773] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE The study aims to detect regions at risk for (pre-)osteoarthritis in the tibiofemoral joint of young professional soccer players by evaluating cartilage composition by T2 mapping in a 3 T magnetic resonance imaging setting. METHODS In this longitudinal study, 20 professional adolescent soccer players were included. Tibiofemoral cartilage was assessed by quantitative T2 mapping and T2 values were evaluated by regions of interest analysis. Statistical evaluation, using Wilcoxon signed-rank tests, was performed to compare global T2 values and subregional T2 values between a baseline and a follow-up investigation 4.3 years later. Based on the average of playing time (15 years) we divided the cohort in 2 groups and differences were evaluated. RESULTS When comparing baseline and follow-up, our findings showed statistically significant increases of the global medial tibial and femoral T2 values. The most noticeable results of the subregional T2 analysis were statistically significant increases in the medial posterior zones (deep femoral 36.1 vs. 39.5, P = 0.001; superficial femoral 57.0 vs. 62.4, P = 0.034; deep tibial 28.3 vs. 34.1, P = 0.009; superficial tibial 43.2 vs. 55.3, P = 0.002). CONCLUSION The elevation of T2 values in the medial, especially medial posterior, compartment of the knee joint indicates that these regions are at risk for early cartilage degeneration already at the time of adolescence. The findings can help individualize and optimize training concepts and to be aware of the chronic stress on these vulnerable areas. Prevention programs should be established in young players to avoid further cartilage damage.
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Affiliation(s)
- Hanna Schenk
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - David Simon
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany,Department of Internal Medicine
3–Rheumatology and Immunology, University Hospital of Erlangen, Erlangen,
Germany
| | - Leonie Waldenmeier
- Department of Internal Medicine,
University Hospital of Basel, Basel, Switzerland
| | - Christoph Evers
- Department of Radiooncology, University
Hospital of Halle/Saale, Halle, Germany
| | - Rolf Janka
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany,Department of Radiology, University
Hospital of Erlangen, Erlangen, Germany
| | - Goetz H. Welsch
- UKE Athleticum, University Hospital
Hamburg-Eppendorf, Hamburg, Germany
| | - Milena L. Pachowsky
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany,Department of Internal Medicine
3–Rheumatology and Immunology, University Hospital of Erlangen, Erlangen,
Germany,Department of Trauma and Orthopedic
Surgery, University Hospital of Erlangen, Erlangen, Germany,Milena L. Pachowsky, Department of Trauma
and Orthopedic Surgery, University Hospital of Erlangen, Maximiliansplatz 1,
Erlangen 91054, Germany.
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7
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The Influence of Running on Lower Limb Cartilage: A Systematic Review and Meta-analysis. Sports Med 2021; 52:55-74. [PMID: 34478109 DOI: 10.1007/s40279-021-01533-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Running is a popular activity practiced worldwide. It is important to understand how running affects joint health to provide recommendations to sports medicine practitioners and runners. OBJECTIVE Our aim was to summarize the influence of running on lower limb cartilage morphology and composition using quantitative magnetic resonance imaging (MRI). METHODS Prospective repeated-measures studies evaluating cartilage using MRI before and after running were included. Data sources included Pubmed, Embase, CINAHL, SportDiscus, Web of Science, and Cochrane Central Registry of Controlled Trials. Qualitative analyses considered the number and methodological quality ratings of studies based on the QualSyst tool, and recommendations were based on the strength of evidence (strong, moderate, limited, or very limited). Quantitative analysis involved meta-analyses, for which effect sizes were calculated as Hedge's g standardized mean differences. RESULTS We included 43 articles, assessing seven outcomes (lesions, volume, thickness, glycosaminoglycan content, and T1ρ, T2, and T2* relaxation times). Nineteen articles were rated as high quality, 24 were rated as moderate quality, and none were rated as low quality. Qualitative analyses suggest that running may cause an immediate reduction in knee cartilage volume, thickness, as well as T1ρ and T2 relaxation times immediately; however, these changes did not persist. Meta-analyses revealed a small and moderate decrease immediately following a single running bout in T2 relaxation time in the medial femur and tibia, respectively. Qualitative analyses indicated that the influence of repeated exposure to running on cartilage morphology and composition was limited. Despite conflicting evidence regarding pre-existing knee cartilage lesions, moderate evidence suggests that running does not lead to the formation of new lesions. Repeated running exposure did not cause changes to foot and ankle cartilage thickness or composition. CONCLUSIONS Changes to lower limb cartilage following running are transient. Immediate changes to cartilage morphology and composition, which likely reflect natural fluid dynamics, do not persist and were generally not significant when pooled statistically. Results suggest that cartilage recovers well from a single running bout and adapts to repeated exposure. Given that moderate evidence indicates that running does not lead to new lesions, future trials should focus on clinical populations, such as those with osteoarthritis. TRIAL REGISTRATION Not applicable.
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8
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Kessler DA, MacKay JW, McDonald S, McDonnell S, Grainger AJ, Roberts AR, Janiczek RL, Graves MJ, Kaggie JD, Gilbert FJ. Effectively Measuring Exercise-Related Variations in T1ρ and T2 Relaxation Times of Healthy Articular Cartilage. J Magn Reson Imaging 2020; 52:1753-1764. [PMID: 32677070 DOI: 10.1002/jmri.27278] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Determining the compositional response of articular cartilage to dynamic joint-loading using MRI may be a more sensitive assessment of cartilage status than conventional static imaging. However, distinguishing the effects of joint-loading vs. inherent measurement variability remains difficult, as the repeatability of these quantitative methods is often not assessed or reported. PURPOSE To assess exercise-induced changes in femoral, tibial, and patellar articular cartilage composition and compare these against measurement repeatability. STUDY TYPE Prospective observational study. POPULATION Phantom and 19 healthy participants. FIELD STRENGTH/SEQUENCE 3T; 3D fat-saturated spoiled gradient recalled-echo; T1ρ - and T2 -prepared pseudosteady-state 3D fast spin echo. ASSESSMENT The intrasessional repeatability of T1ρ and T2 relaxation mapping, with and without knee repositioning between two successive measurements, was determined in 10 knees. T1ρ and T2 relaxation mapping of nine knees was performed before and at multiple timepoints after a 5-minute repeated, joint-loading stepping activity. 3D surface models were created from patellar, femoral, and tibial articular cartilage. STATISTICAL TESTS Repeatability was assessed using root-mean-squared-CV (RMS-CV). Using Bland-Altman analysis, thresholds defined as the smallest detectable difference (SDD) were determined from the repeatability data with knee repositioning. RESULTS Without knee repositioning, both surface-averaged T1ρ and T2 were very repeatable on all cartilage surfaces, with RMS-CV <1.1%. Repositioning of the knee had the greatest effect on T1ρ of patellar cartilage with the surface-averaged RMS-CV = 4.8%. While T1ρ showed the greatest response to exercise at the patellofemoral cartilage region, the largest changes in T2 were determined in the lateral femorotibial region. Following thresholding, significant (>SDD) average exercise-induced in T1ρ and T2 of femoral (-8.0% and -5.3%), lateral tibial (-6.9% and -5.9%), medial tibial (+5.8% and +2.9%), and patellar (-7.9% and +2.8%) cartilage were observed. DATA CONCLUSION Joint-loading with a stepping activity resulted in T1ρ and T2 changes above background measurement error. EVIDENCE LEVEL 2 TECHNICAL EFFICACY STAGE: 1 J. MAGN. RESON. IMAGING 2020;52:1753-1764.
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Affiliation(s)
| | - James W MacKay
- Department of Radiology, University of Cambridge, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Scott McDonald
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Stephen McDonnell
- Division of Trauma and Orthopaedics, Department of Surgery, University of Cambridge, Cambridge, UK
| | - Andrew J Grainger
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | | | | | - Martin J Graves
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | | | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, UK.,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
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9
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Schütz U, Ehrhardt M, Göd S, Billich C, Beer M, Trattnig S. A mobile MRI field study of the biochemical cartilage reaction of the knee joint during a 4,486 km transcontinental multistage ultra-marathon using T2* mapping. Sci Rep 2020; 10:8157. [PMID: 32424133 PMCID: PMC7235258 DOI: 10.1038/s41598-020-64994-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/21/2020] [Indexed: 02/08/2023] Open
Abstract
Nearly nothing is known about the consequences of ultra-long-distance running on knee cartilage. In this mobile MRI field study, we analysed the biochemical effects of a 4,486 km transcontinental multistage ultra-marathon on femorotibial joint (FTJ) cartilage. Serial MRI data were acquired from 22 subjects (20 male, 18 finisher) using a 1.5 T MR scanner mounted on a 38-ton trailer, travelling with the participants of the TransEurope FootRace (TEFR) day by day over 64 stages. The statistical analyses focused on intrachondral T2* behaviour during the course of the TEFR as the main outcome variable of interest. T2* mapping (sagittal FLASH T2* weighted gradient echo) is a validated and highly accurate method for quantitative compositional cartilage analysis of specific weightbearing areas of the FTJ. T2* mapping is sensitive to changes in the equilibrium of free intrachondral water, which depends on the content and orientation of collagen and the proteoglycan content in the extracellular cartilage matrix. Within the first 1,100 km, a significant running load-induced T2* increase occurred in all joint regions: 44.0% femoral-lateral, 42.9% tibial-lateral, 34.9% femoral-medial, and 25.1% tibial-medial. Osteochondral lesions showed no relevant changes or new occurrence during the TEFR. The reasons for stopping the race were not associated with knee problems. As no further T2* elevation was found in the second half of the TEFR but a decreasing T2* trend (recovery) was observed after the 3,500 km run, we assume that no further softening of the cartilage occurs with ongoing running burden over ultra-long distances extending 4,500 km. Instead, we assume the ability of the FTJ cartilage matrix to reorganize and adapt to the load.
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Affiliation(s)
- Uwe Schütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany.
| | - Martin Ehrhardt
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany
| | - Sabine Göd
- MR Centre of Excellence- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria
| | - Christian Billich
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany
| | - Siegfried Trattnig
- MR Centre of Excellence- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria
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10
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Quantifying the biochemical state of knee cartilage in response to running using T1rho magnetic resonance imaging. Sci Rep 2020; 10:1870. [PMID: 32024873 PMCID: PMC7002650 DOI: 10.1038/s41598-020-58573-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
Roughly 20% of Americans run annually, yet how this exercise influences knee cartilage health is poorly understood. To address this question, quantitative magnetic resonance imaging (MRI) can be used to infer the biochemical state of cartilage. Specifically, T1rho relaxation times are inversely related to the proteoglycan concentration in cartilage. In this study, T1rho MRI was performed on the dominant knee of eight asymptomatic, male runners before, immediately after, and 24 hours after running 3 and 10 miles. Overall, (mean ± SEM) patellar, tibial, and femoral cartilage T1rho relaxation times significantly decreased immediately after running 3 (65 ± 3 ms to 62 ± 3 ms; p = 0.04) and 10 (69 ± 4 ms to 62 ± 3 ms; p < 0.001) miles. No significant differences between pre-exercise and recovery T1rho values were observed for either distance (3 mile: p = 0.8; 10 mile: p = 0.08). Percent decreases in T1rho relaxation times were significantly larger following 10 mile runs as compared to 3 mile runs (11 ± 1% vs. 4 ± 1%; p = 0.02). This data suggests that alterations to the relative proteoglycan concentration of knee cartilage due to water flow are mitigated within 24 hours of running up to 10 miles. This information may inform safe exercise and recovery protocols in asymptomatic male runners by characterizing running-induced changes in knee cartilage composition.
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11
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Esculier JF, Jarrett M, Krowchuk NM, Rauscher A, Wiggermann V, Taunton JE, Wilson DR, Gatti AA, Hunt MA. Cartilage recovery in runners with and without knee osteoarthritis: A pilot study. Knee 2019; 26:1049-1057. [PMID: 31434630 DOI: 10.1016/j.knee.2019.07.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/17/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Running is an easy way of meeting physical activity recommendations for individuals with knee osteoarthritis (KOA); however, it remains unknown how their cartilage reacts to running. The objective of this pilot study was to compare the effects of 30 min of running on T2 and T1ρ relaxation times of tibiofemoral cartilage in female runners with and without KOA. METHODS Ten female runners with symptomatic KOA (mean age 52.6 ± 7.6 years) and 10 without KOA (mean age 52.5 ± 7.8 years) ran for 30 min on a treadmill. Tibiofemoral cartilage T2 and T1ρ relaxation times were measured using magnetic resonance imaging prior to and immediately after the bout of running. Repeated-measures analyses of covariance (ANCOVA) were conducted to examine between-group differences across scanning times. RESULTS No Group × Time interactions were found for T2 (P ≥ 0.076) or T1ρ (P ≥ 0.288) relaxation times. However, runners with KOA showed increased T2 values compared with pre-running in the medial and lateral femur 55 min post-running (5.4 to 5.5%, P < 0.022) and in all four tibiofemoral compartments 90 min post-running (6.9 to 11.1%, P < 0.01). A significant group effect was found for T1ρ in the medial femur, with greater values in those with KOA compared with controls. CONCLUSION While Group × Time interactions in T2 and T1ρ relaxation times remained statistically insignificant, the observed significant increases in T2 in runners with tibiofemoral osteoarthritis TFOA may suggest slower and continuing changes in the cartilage and thus a need for longer recovery after running. Future research should investigate the effects of repeated exposure to running.
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Affiliation(s)
- Jean-Francois Esculier
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Michael Jarrett
- Population Data BC, University of British Columbia, Vancouver, BC, Canada
| | - Natasha M Krowchuk
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Alexander Rauscher
- UBC MRI Research Centre, University of British Columbia, Vancouver, BC, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Vanessa Wiggermann
- UBC MRI Research Centre, University of British Columbia, Vancouver, BC, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Jack E Taunton
- Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - David R Wilson
- Department of Orthopaedics and Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada; Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Anthony A Gatti
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; NeuralSeg Ltd, Hamilton, ON, Canada
| | - Michael A Hunt
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Karanfil Y, Babayeva N, Dönmez G, Diren HB, Eryılmaz M, Doral MN, Korkusuz F. Thirty Minutes of Running Exercise Decreases T2 Signal Intensity but Not Thickness of the Knee Joint Cartilage: A 3.0-T Magnetic Resonance Imaging Study. Cartilage 2019; 10:444-450. [PMID: 29676169 PMCID: PMC6755866 DOI: 10.1177/1947603518770246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Recent studies showed a potential of magnetic resonance imaging (MRI), which can be used as an additional tool for diagnosing cartilage degeneration in the early stage. We designed a cross-sectional study in order to evaluate knee joint cartilage adaptation to running, using 3.0-T MRI equipped with the 3-dimensional turbo spin echo (VISTA = Volume ISotropic Turbo spin echo Acquisition) software. By this thickness (mm) and signal intensity (mean pixel value) can be quantified, which could be closely related to the fluid content of the knee joint cartilage, before and after running. METHODS A total of 22 males, aged 18 to 35 years, dominant (right) and nondominant (left) knees were assessed before and after 30 minutes of running. Cartilage thickness and signal intensity of surfaces of the patella, medial and lateral femoral and tibial condyles were measured. RESULTS Cartilage thickness of the lateral condyle decreased at the dominant knee, while it increased at the medial tibial plateau. Signal intensity decreased at all locations, except the lateral patella in both knees. The most obvious decrease in signal intensity (10.6%) was at the medial tibial plateau from 949.8 to 849.0 of the dominant knee. CONCLUSION There was an increase in thickness measurements and decrease in signal intensity in medial tibial plateau of the dominant knee after 30 minutes of running. This outcome could be related to fluid outflow from the tissue. Greater reductions in the medial tibial plateau cartilage indicate greater load sharing by these areas of the joint during a 30-minute running.
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Affiliation(s)
| | - Naila Babayeva
- Department of Sports Medicine, Hacettepe University, Ankara, Turkey
| | - Gürhan Dönmez
- Department of Sports Medicine, Hacettepe University, Ankara, Turkey
| | - H. Barış Diren
- Department of Radiology, Medicana International Ankara Hospital, Ankara, Turkey
| | | | - Mahmut Nedim Doral
- Department of Orthopaedics and Traumatology, Hacettepe University, Ankara, Turkey
| | - Feza Korkusuz
- Department of Sports Medicine, Hacettepe University, Ankara, Turkey,Feza Korkusuz, Hacettepe Üniversitesi Tıp Fakültesi Hastaneleri, Spor Hekimliği AD, Sıhhiye, Ankara 06100, Turkey.
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13
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Buchholtz KA, Lambert MI, Bosch A, Burgess TL. Calf muscle architecture and function in ultra runners and low physical activity individuals: A comparative review. TRANSLATIONAL SPORTS MEDICINE 2018. [DOI: 10.1002/tsm2.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kim A. Buchholtz
- Division of Physiotherapy; Department of Health and Rehabilitation Sciences; University of Cape Town; Cape Town South Africa
| | - Michael I. Lambert
- Division of Exercise Science and Sports Medicine; Department of Human Biology; University of Cape Town; Cape Town South Africa
| | - Andrew Bosch
- Division of Exercise Science and Sports Medicine; Department of Human Biology; University of Cape Town; Cape Town South Africa
| | - Theresa L. Burgess
- Division of Physiotherapy; Department of Health and Rehabilitation Sciences; University of Cape Town; Cape Town South Africa
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14
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Williams A, Titchenal M, Andriacchi T, Chu C. MRI UTE-T2* profile characteristics correlate to walking mechanics and patient reported outcomes 2 years after ACL reconstruction. Osteoarthritis Cartilage 2018; 26:569-579. [PMID: 29426012 PMCID: PMC6548437 DOI: 10.1016/j.joca.2018.01.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 01/08/2018] [Accepted: 01/16/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Quantitative magnetic resonance imaging (MRI) ultrashort echo time (UTE) T2* is sensitive to cartilage deep tissue matrix changes after anterior cruciate ligament reconstruction (ACLR). This study was performed to determine whether UTE-T2* profile analysis is a useful clinical metric for assessing cartilage matrix degeneration. This work tests the hypotheses that UTE-T2* depthwise rates of change (profile slopes) correlate with clinical outcome metrics of walking mechanics and patient reported outcomes (PRO) in patients 2 years after ACLR. DESIGN Thirty-six patients 2 years after ACLR completed knee MRI, gait analysis, and PRO. UTE-T2* maps were generated from MRI images and depthwise UTE-T2* profiles were calculated for weight-bearing cartilage in the medial compartment. UTE-T2* profiles from 14 uninjured subjects provided reference values. UTE-T2* profile characteristics, including several different measures of profile slope, were tested for correlation to kinetic and kinematic measures of gait and also to PRO. RESULTS Decreasing UTE-T2* profile slopes in ACLR knees moderately correlated with increasing knee adduction moments (r = 0.41, P < 0.015), greater external tibial rotation (r = 0.44, P = 0.007), and moderately negatively correlated with PRO (r = -0.36, P = 0.032). UTE-T2* profiles from both ACLR and contralateral knees of ACLR subjects differed from that of uninjured controls (P < 0.015). CONCLUSIONS The results of this study suggest that decreasing UTE-T2* profile slopes reflect cartilage deep tissue collagen matrix disruption in a population at increased risk for knee osteoarthritis (OA). That UTE-T2* profiles were associated with mechanical and patient reported measures of clinical outcomes support further study into a potential mechanistic relationship between these factors and OA development.
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Affiliation(s)
- A.A. Williams
- Department of Orthopedic Surgery, Stanford University,
Stanford, CA, USA,Veterans Affairs Palo Alto Health Care System, Palo Alto,
CA, USA
| | - M.R. Titchenal
- Department of Orthopedic Surgery, Stanford University,
Stanford, CA, USA,Mechanical Engineering, Stanford University, Stanford, CA,
USA,Veterans Affairs Palo Alto Health Care System, Palo Alto,
CA, USA
| | - T.P. Andriacchi
- Department of Orthopedic Surgery, Stanford University,
Stanford, CA, USA,Mechanical Engineering, Stanford University, Stanford, CA,
USA,Veterans Affairs Palo Alto Health Care System, Palo Alto,
CA, USA
| | - C.R. Chu
- Department of Orthopedic Surgery, Stanford University,
Stanford, CA, USA,Veterans Affairs Palo Alto Health Care System, Palo Alto,
CA, USA,Address correspondence and reprint requests to: C.R.
Chu, Stanford University Medical Center, Department of Orthopaedic Surgery, 450
Broadway Street, MC 6342, Redwood City, CA 94063, USA. Fax: 1-650-721-3470.
(C.R. Chu)
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15
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Mars M, Chelli M, Tbini Z, Ladeb F, Gharbi S. MRI T2 Mapping of Knee Articular Cartilage Using Different Acquisition Sequences and Calculation Methods at 1.5 Tesla. Med Princ Pract 2018; 27:443-450. [PMID: 29895028 PMCID: PMC6243913 DOI: 10.1159/000490796] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 06/12/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study aims to determine how magnetic resonance imaging (MRI) acquisition techniques and calculation methods affect T2 values of knee cartilage at 1.5 tesla and to identify sequences that can be used for high-resolution T2 mapping in short scanning times. MATERIALS AND METHODS This study was performed on phantom and 29 patients who underwent MRI of the knee joint at 1.5 tesla. The protocol includes T2 mapping sequences based on Single-Echo Spin Echo (SESE), Multi-Echo Spin Echo (MESE), Fast Spin Echo (FSE) and Turbo Gradient Spin Echo (TGSE). The T2 relaxation times were quantified and evaluated using three calculation methods (MapIt, Syngo Offline and mono-exponential fit). signal-to-noise ratios (SNR) were measured in all sequences. All statistical analyses were performed using the t-test. RESULTS The average T2 values in phantom were 41.7 ± 13.8 ms for SESE, 43.2 ± 14.4 ms for MESE, 42.4 ± 14.1 ms for FSE and 44 ± 14.5 ms for TGSE. In the patient study, the mean differences were 6.5 ± 8.2 ms, 7.8 ± 7.6 ms and 8.4 ± 14.2 ms for MESE, FSE and TGSE compared to SESE, respectively; these statistical results were not significantly different (p > 0.05). The comparison between the three calculation methods showed no significant difference (p > 0.05). The t-test showed no significant difference between SNR values for all sequences. CONCLUSION T2 values depend not only on the sequence type but also on the calculation method. None of the sequences revealed significant differences compared to the SESE reference sequence. TGSE with its short scanning time can be used for high-resolution T2 mapping.
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Affiliation(s)
- Mokhtar Mars
- Tunis University EL Manar, Higher Institute of Medical Technologies of Tunis, Research Laboratory of Biophysics and Medical Technologies, Tunis, Tunisia
- *Mokhtar Mars, 29 Rue Imam Chafai La Petite Ariana, Jaafar, 2083 Tunis (Tunisia), E-Mail
| | - Mouna Chelli
- Tunis University EL Manar, Faculty of Medicine of Tunis, Department of Radiology, Kassab Institute of Orthopedics, Ksar Saïd, Tunis, Tunisia
| | - Zeineb Tbini
- Tunis University EL Manar, Higher Institute of Medical Technologies of Tunis, Research Laboratory of Biophysics and Medical Technologies, Tunis, Tunisia
| | - Fethi Ladeb
- Tunis University EL Manar, Faculty of Medicine of Tunis, Department of Radiology, Kassab Institute of Orthopedics, Ksar Saïd, Tunis, Tunisia
| | - Souha Gharbi
- Tunis University EL Manar, Higher Institute of Medical Technologies of Tunis, Research Laboratory of Biophysics and Medical Technologies, Tunis, Tunisia
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Abstract
OBJECTIVE The objective of this study was to assess the feasibility of T2 relaxation time measurements of the sacroiliac joints. SUBJECTS AND METHODS The sacroiliac joints of 40 patients were imaged by 3-T MRI using an oblique axial multislice multiecho spin-echo T2-weighted sequence. Manual plotting and automatic subdivision of ROIs allowed us to obtain T2 values for up to 48 different areas per patient (posterior and anterior parts, sacral, intermediate, and iliac parts). Intraand interobserver reproducibility of T2 values were calculated after independent assessment by two musculoskeletal radiologists. RESULTS A total of 1656 measurement sites could be analyzed. Mean (± SD) T2 values were 40.6 ± 6.7 ms and 41.2 ± 6.3 ms for observer 1 and 39.9 ± 6.6 ms for observer 2. The intraobserver intraclass correlation coefficient was 0.72 (95% CI, 0.70-0.74), and the interobserver intraclass correlation coefficient was 0.71 (95% CI, 0.68-0.72). CONCLUSION Our study shows the feasibility of T2 relaxation time measurements at the sacroiliac joints.
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17
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Hoessly ML, Wildi LM. Magnetic Resonance Imaging Findings in the Knee Before and After Long-Distance Running-Documentation of Irreversible Structural Damage? A Systematic Review. Am J Sports Med 2017; 45:1206-1217. [PMID: 27519676 DOI: 10.1177/0363546516656180] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Various studies have investigated structural knee changes after running, with conflicting results. PURPOSE To perform a systematic review of acute changes in knee structures as detected by magnetic resonance imaging (MRI) after running and assess the reversibility of these changes. STUDY DESIGN Systematic review. METHODS A systematic literature search in Medline, Cochrane, Embase, and Scopus was performed. Articles that fulfilled predefined inclusion criteria were included and systematically reviewed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. RESULTS A total of 19 studies were included in this review. All studies performed standard knee MRI; 6 studies additionally performed T1ρ and T2 mapping. Sixteen studies assessed cartilage or meniscal morphological changes. Ten found no significant morphological changes after running. Six studies showed significant changes at the first follow-up. Six performed a second follow-up. Five showed no change compared with baseline and the first follow-up, and 1 showed a significant recovery compared with the first follow-up and no significant difference compared with baseline. Five of the 6 studies performing T1ρ and T2 mapping found significant changes in T2 and T1ρ values at the first follow-up. Three performed a second follow-up. Two found a significant recovery of T2 but no recovery of T1ρ. One study did not find a significant change compared with baseline. Ten studies assessed the patellar tendon, ligaments, synovial fluid, or subchondral bone. Changes at the first follow-up were not significant. A second follow-up was performed in 5 studies. All studies discovered recovery from the first follow-up. CONCLUSION These data suggest that healthy athletes who have no risk factors for degenerative joint disease may present fleeting quantitative alterations after running. No irreversible, qualitative harmful effects seemed to occur, with the exception of persistent T1ρ elevation representing a proteoglycan depletion. Whether T1ρ changes need more than 3 months to recover or represent permanent structural damage remains to be investigated.
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Affiliation(s)
- Menduri L Hoessly
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Lukas M Wildi
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
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18
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Gatti AA, Noseworthy MD, Stratford PW, Brenneman EC, Totterman S, Tamez-Peña J, Maly MR. Acute changes in knee cartilage transverse relaxation time after running and bicycling. J Biomech 2017; 53:171-177. [DOI: 10.1016/j.jbiomech.2017.01.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 11/25/2022]
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19
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Cattano NM, Driban JB, Cameron KL, Sitler MR. Impact of physical activity and mechanical loading on biomarkers typically used in osteoarthritis assessment: current concepts and knowledge gaps. Ther Adv Musculoskelet Dis 2016; 9:11-21. [PMID: 28101145 DOI: 10.1177/1759720x16670613] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
There is an ongoing need to develop prognostic and diagnostic biomarkers for osteoarthritis (OA). Understanding how biomarkers change in response to physical activity may be vital for understanding if a patient has a joint that is failing to adapt to a given loading stimulus. The purpose of this review is to describe how biomarker changes after joint loading may help detect early OA and determine prognosis. This may help to inform and more specifically target interventions and clinical trials. We conducted a critical review of the relevant literature that was published to January 2016. There is extensive OA biomarker research, specifically basal biomarker concentrations; however, there is limited research surrounding biomarker response to load. Some of this limited research includes the response of minimal biomarkers reflecting bone, synovium, inflammatory, and cartilage responses to load. Biomarker changes occur in bone and cartilage in response to a variety of activities and are influenced by variables such as body weight, load, vibration, and activity time. Biomarker responses to loading tasks may serve as a measure of overall joint health and be predictive of structural changes. Biomarkers adapt to training over time, and this may indicate a need for a gradual return to physical activity after an injury to allow time for joint tissues to adapt to load. Biomarker responses to physical activity may be monitored to determine appropriate loading levels and safety for return to activity.
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Affiliation(s)
- Nicole M Cattano
- West Chester University of Pennsylvania, 855 South New Street, 222L Sturzebecker HSC, West Chester, PA 19383, USA
| | | | - Kenneth L Cameron
- John A. Feagin Jr Sports Medicine Fellowship, Department of Orthopaedic Surgery, Keller Army Hospital, West Point, New York, USA
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Behzadi C, Welsch GH, Laqmani A, Henes FO, Kaul MG, Schoen G, Adam G, Regier M. The immediate effect of long-distance running on T2 and T2* relaxation times of articular cartilage of the knee in young healthy adults at 3.0 T MR imaging. Br J Radiol 2016; 89:20151075. [PMID: 27336705 DOI: 10.1259/bjr.20151075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To quantitatively assess the immediate effect of long-distance running on T2 and T2* relaxation times of the articular cartilage of the knee at 3.0 T in young healthy adults. METHODS 30 healthy male adults (18-31 years) who perform sports at an amateur level underwent an initial MRI at 3.0 T with T2 weighted [16 echo times (TEs): 9.7-154.6 ms] and T2* weighted (24 TEs: 4.6-53.6 ms) relaxation measurements. Thereafter, all participants performed a 45-min run. After the run, all individuals were immediately re-examined. Data sets were post-processed using dedicated software (ImageJ; National Institute of Health, Bethesda, MD). 22 regions of interest were manually drawn in segmented areas of the femoral, tibial and patellar cartilage. For statistical evaluation, Pearson product-moment correlation coefficients and confidence intervals were computed. RESULTS Mean initial values were 35.7 ms for T2 and 25.1 ms for T2*. After the run, a significant decrease in the mean T2 and T2* relaxation times was observed for all segments in all participants. A mean decrease of relaxation time was observed for T2 with 4.6 ms (±3.6 ms) and for T2* with 3.6 ms (±5.1 ms) after running. CONCLUSION A significant decrease could be observed in all cartilage segments for both biomarkers. Both quantitative techniques, T2 and T2*, seem to be valuable parameters in the evaluation of immediate changes in the cartilage ultrastructure after running. ADVANCES IN KNOWLEDGE This is the first direct comparison of immediate changes in T2 and T2* relaxation times after running in healthy adults.
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Affiliation(s)
- Cyrus Behzadi
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Goetz H Welsch
- 2 Department of Sports Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Azien Laqmani
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Frank O Henes
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Michael G Kaul
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Schoen
- 3 Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Regier
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
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Zuo H, Yao W, Qu N, Yang S, Wang J, Cui X. Quantitative evaluation in combination with nonquantitative evaluation in early patellar cartilage osteoarthritis at 3.0 T. Clin Interv Aging 2014; 9:1133-43. [PMID: 25075182 PMCID: PMC4106963 DOI: 10.2147/cia.s65871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose To evaluate quantitative T1 and T2 relaxation times and magnetization transfer ratios (MTRs) in the early diagnosis of patellar cartilage osteoarthritis (OA) and to quantify and possibly refine the current Kellgren-Lawrence score criteria. Materials and methods A total of 92 cases of knee joints with 40 normal volunteers and 30 patients with OA were prospectively evaluated. The knee joints with OA were divided into mild and moderate groups according to the Kellgren-Lawrence score criteria. The discriminative analysis method was used to analyze the accuracy of the original grouped cases correctly classified by age, sex, T1 relaxation times, T2 relaxation times, and MTR values. Linear regression analysis was used between T1 relaxation time, T2 relaxation time, and MTR values. Results The mean T1 relaxation times decreased with the severity of OA, and a significant difference was only found between the normal and moderate OA groups (P<0.05). The mean T2 relaxation times increased, and significant differences were found between the normal and mild OA groups and the normal and moderate OA groups (P<0.001). The MTR values were 35.8%±4.2%, 36.1%±3.2%, and 35.4%±3.8%, respectively. There were no significant differences between the normal and OA groups. In addition, T1 relaxation times were positively correlated with MTR values (P<0.01). A discriminative analysis using a synthesis of all the influential factors indicated a high accuracy rate (93.9%) for the correct classification of the original grouped cases. Conclusion Quantitative T1 and T2 relaxation times were useful in the diagnosis of early OA; T2 relaxation times were more relatively sensitive. The functional usefulness of MTR values may be limited. T1 relaxation times positively correlated with MTR values. Multiple quantitative parameters, combined with some relative nonquantitative clinical parameters and Kellgren-Lawrence scores, may be useful in the early stage of OA and provide better information for clinical treatment and follow-up.
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Affiliation(s)
- Houdong Zuo
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Weiwu Yao
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Nan Qu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Shixun Yang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Jianhua Wang
- Department of Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xiaojiang Cui
- Department of Surgery, Department of Obstetrics and Gynecology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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