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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-04-2021 | KNEE

Mean femoral cartilage thickness is higher in athletes as compared with sedentary individuals

Authors: Naila Babayeva, Gürhan Dönmez, Levent Özçakar, Şerife Şeyma Torgutalp, Levend Karaçoban, Emre Gedik, Feza Korkusuz, Mahmut Nedim Doral

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2021

Abstract

Purpose

It is unclear how high-intensity physical activity (HIPA) affects the knee joint, specifically the femoral cartilage (FC). Therefore, the aims of this study were to evaluate FC thickness via ultrasound among elite athletes involved in different types of HIPA, and to determine whether there is a correlation between serum cartilage oligomeric matrix protein (sCOMP) and rectus femoris (RF) thickness.

Method

A total of 132 male individuals participated in this study and were assigned to two groups, the sedentary (n = 43, 23.9 ± 3.7) and athlete groups (n = 89, 22.7 ± 4.6), which did not significantly differ in age. The athletes were elite and performed HIPA during sports such as volleyball (n = 20), soccer (n = 21), basketball (n = 28), and weightlifting (n = 20). RF thickness and three (mid-point) measurements were obtained for each knee. The mean FC thickness for each knee was defined as the sum of the medial, lateral condyles, and intercondylar areas. Blood samples for sCOMP analyses were also obtained.

Results

All the measurements of the FC of both knees were significantly higher in the athletes than in the sedentary individuals (p < 0.001 and p = 0.001). The mean right and left FC values were also higher in the athletes (p < 0.001). Multiple linear regression analysis showed that participation in sporting activities was a significant predictor associated with the right and left mean FC thickness (p < 0.001 for both). No significant differences in the sCOMP levels were found between the two groups.

Conclusion

It was found that the mean FC was higher among athletes than among sedentary individuals. As a result, it is suggested that sports’ participation is an independent factor associated with the right and left mean FC thickness.

Level of evidence

III.

Abdelghani BK, Slouma M, Souabni L, Kassab S, Chekili S, Laatar A, Zakraoui L (2014) AB0988 effect of football on knee cartilage thickness: an ultrasonographic assessment. Ann Rheum Dis 73(2):1127–1127

Anandacoomarasamy A, Leibman S, Smith G, Caterson I, Giuffre B, Fransen M et al (2012) Weight loss in obese people has structure-modifying effects on medial but not on lateral knee articular cartilage. Ann Rheum Dis 71(1):26–32PubMed

Antony B, Venn A, Cicuttini F, March L, Blizzard L, Dwyer T et al (2016) Association of body composition and hormonal and inflammatory factors with tibial cartilage volume and sex difference in cartilage volume in young adults. Arthritis Care Res 68(4):517–525

Bank R, Bayliss M, Lafeber F, Maroudas A, Tekoppele J (1998) Ageing and zonal variation in post-translational modification of collagen in normal human articular cartilage. Biochem J 330(1):345–351PubMedPubMedCentral

Boesen M, Ellegaard K, Henriksen M, Gudbergsen H, Hansen P, Bliddal H et al (2017) Osteoarthritis year in review 2016: imaging. Osteoarthr Cartil 25(2):216–226

Buckwalter JA (2003) Sports, joint injury, and posttraumatic osteoarthritis. J Orthop Sports Phys Ther 33(10):578–588PubMed

Buckwalter JA, Lane NE (1997) Athletics and osteoarthritis. Am J Sports Med 25(6):873–881PubMed

Castaño Betancourt MC, Cailotto F, Kerkhof HJ, Cornelis FMF, Doherty SA, Hart DJ et al (2012) Genome-wide association and functional studies identify the DOT1L gene to be involved in cartilage thickness and hip osteoarthritis. Proc Natl Acad Sci USA 109(21):8218–8223PubMed

Celik O, Salci Y, Ak E, Kalaci A, Korkusuz F (2013) Serum cartilage oligomeric matrix protein accumulation decreases significantly after 12weeks of running but not swimming and cycling training—A randomised controlled trial. Knee 20(1):19–25PubMed

10.

Cicuttini F, Forbes A, Morris K, Darling S, Bailey M, Stuckey S (1999) Gender differences in knee cartilage volume as measured by magnetic resonance imaging. Osteoarthr Cartil 7(3):265–271

11.

Ding C, Cicuttini F, Scott F, Glisson M, Jones G (2003) Sex differences in knee cartilage volume in adults: role of body and bone size, age and physical activity. Rheumatology 42(11):1317–1323PubMed

12.

Drawer S, Fuller CW (2001) Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br J Sports Med 35(6):402–408PubMedPubMedCentral

13.

Eckstein F, Faber S, Mühlbauer R, Hohe J, Englmeier K-H, Reiser M, Putz R (2002) Functional adaptation of human joints to mechanical stimuli. Osteoarthr Cartil 10(1):44–50

14.

Eckstein F, Hudelmaier M, Putz R (2006) The effects of exercise on human articular cartilage. J Anat 208(4):491–512PubMedPubMedCentral

15.

Erhart-Hledik JC, Favre J, Asay JL, Smith RL, Giori NJ, Mündermann A, Andriacchi TP (2012) A relationship between mechanically-induced changes in serum cartilage oligomeric matrix protein (COMP) and changes in cartilage thickness after 5 years. Osteoarthr Cartil 20(11):1309–1315

16.

Evangelou E, Kerkhof HJ, Styrkarsdottir U, Ntzani EE, Bos SD, Esko T et al (2014) A meta-analysis of genome-wide association studies identifies novel variants associated with osteoarthritis of the hip. Ann Rheum Dis 73(12):2130–2136PubMed

17.

Firner S, Willwacher S, de Marées M, Bleuel J, Zaucke F, Brüggemann GP, Niehoff A (2018) Effect of increased mechanical knee joint loading during running on the serum concentration of cartilage oligomeric matrix protein (COMP). J Orthop Res 36(7):1937–1946PubMed

18.

Gratzke C, Hudelmaier M, Hitzl W, Glaser C, Eckstein F (2007) Knee cartilage morphologic characteristics and muscle status of professional weight lifters and sprinters. Am J Sports Med 35(8):1346–1353PubMed

19.

Grzelak P, Domzalski M, Majos A, Podgórski M, Stefanczyk L, Krochmalski M, Polguj M (2014) Thickening of the knee joint cartilage in elite weightlifters as a potential adaptation mechanism. Clin Anat 27(6):920–928PubMed

20.

Hoch JM, Mattacola CG, Bush HM, Medina McKeon JM, Hewett TE, Lattermann C (2012) Longitudinal documentation of serum cartilage oligomeric matrix protein and patient-reported outcomes in collegiate soccer athletes over the course of an athletic season. Am J Sports Med 40(11):2583–2589PubMedPubMedCentral

21.

Hudelmaier M, Glaser C, Hausschild A, Burgkart R, Eckstein F (2006) Effects of joint unloading and reloading on human cartilage morphology and function, muscle cross-sectional areas, and bone density—a quantitative case report. J Musculoskelet Neuronal Interact 6(3):284–290PubMed

22.

Jones G, Bennell K, Cicuttini FM (2003) Effect of physical activity on cartilage development in healthy kids. Br J Sports Med 37(5):382–383PubMedPubMedCentral

23.

Kara M, Tiftik T, Öken Ö, Akkaya N, Tunc H, Özçakar L (2013) Ultrasonographic measurement of femoral cartilage thickness in patients with spinal cord injury. J Rehabil Med 45(2):145–148PubMed

24.

Karanfil Y, Babayeva N, Dönmez G, Diren HB, Eryılmaz M, Doral MN, Korkusuz F (2018) 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 10(4):444–450PubMedPubMedCentral

25.

Kersting UG, Stubendorff JJ, Schmidt MC, Brüggemann GP (2005) Changes in knee cartilage volume and serum COMP concentration after running exercise. Osteoarthr Cartil 13(10):925–934

26.

Kim HJ, Lee YH, Kim CK (2009) Changes in serum cartilage oligomeric matrix protein (COMP), plasma CPK and plasma hs-CRP in relation to running distance in a marathon (42.195 km) and an ultra-marathon (200 km) race. Eur J Appl Physiol 105(5):765–770PubMed

27.

Kujala UM, Kettunen J, Paananen H, Aalto T, Battié MC, Impivaara O, Videman T, Sarna S (1995) Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters. Arthritis Rheum 38(4):539–546PubMed

28.

Malas FÜ, Özçakar L, Kaymak B, Ulaşli A, Güner S, Kara M, Akinci A (2013) Effects of different strength training on muscle architecture: clinical and ultrasonographic evaluation in knee osteoarthritis. PM R 5(8):655–662PubMed

29.

Martel-Pelletier J, Barr AJ, Cicuttini FM, Conaghan PG, Cooper C, Goldring MB et al (2016) Osteoarthritis. Nat Rev Dis Prim 2(1):16072PubMed

30.

Mezhov V, Ciccutini FM, Hanna FS, Brennan SL, Wang YY, Urquhart DM, Wluka AE (2014) Does obesity affect knee cartilage? A systematic review of magnetic resonance imaging data. Obes Rev 15(2):143–157PubMed

31.

Mithoefer K, Peterson L, Zenobi-Wong M, Mandelbaum BR (2015) Cartilage issues in football—today’s problems and tomorrow’s solutions. Br J Sports Med 49(9):590–596PubMedPubMedCentral

32.

Mosher TJ, Liu Y, Torok CM (2010) Functional cartilage MRI T2 mapping: evaluating the effect of age and training on knee cartilage response to running. Osteoarthr Cartil 18(3):358–364

33.

Mühlbauer R, Lukasz S, Faber S, Stammberger T, Eckstein F (2000) Comparison of knee joint cartilage thickness in triathletes and physically inactive volunteers based on magnetic resonance imaging and three-dimensional analysis. Am J Sports Med 28(4):541–546PubMed

34.

Mündermann A, Dyrby CO, Andriacchi TP, King KB (2005) Serum concentration of cartilage oligomeric matrix protein (COMP) is sensitive to physiological cyclic loading in healthy adults. Osteoarthr Cartil 13(1):34–38

35.

Neidhart M, Hauser N, Paulsson M, Dicesare PE, Michel BA, Häuselmann HJ (1997) Small fragments of cartilage oligomeric matrix protein in synovial fluid and serum as markers for cartilage degradation. Br J Rheumatol 36(11):1151–1160PubMed

36.

Neidhart M, Müller-Ladner U, Frey W, Bosserhoff AK, Colombani PC, Frey-Rindova P et al (2000) Increased serum levels of non-collagenous matrix proteins (cartilage oligomeric matrix protein and melanoma inhibitory activity) in marathon runners. Osteoarthr Cartil 8(3):222–229

37.

Özçakar L, Kara M, Wang TG, De Muynck M (2015) EURO-MUSCULUS/USPRM basic scanning protocols: a practical guide for physiatrists. Eur J Phys Rehabil Med 51(4):477–478PubMed

38.

Roberts HM, Moore JP, Griffith-McGeever CL, Fortes MB, Thom JM (2016) The effect of vigorous running and cycling on serum COMP, lubricin, and femoral cartilage thickness: a pilot study. Eur J Appl Physiol 116(8):1467–1477PubMed

39.

Roberts HM, Moore JP, Thom JM (2018) The effect of aerobic walking and lower body resistance exercise on serum COMP and hyaluronan, in both males and females. Eur J Appl Physiol 118(6):1095–1105PubMed

40.

Sakthiswary R, Rajalingam S, Hussein H, Sridharan R, Asrul AW (2017) Cartilage oligomeric matrix protein (COMP) in rheumatoid arthritis and its correlation with sonographic knee cartilage thickness and disease activity. Clin Rheumatol 36(12):2683–2688PubMed

41.

Saxne T, Heinegård D (1992) Cartilage oligomeric matrix protein: a novel marker of cartilage turnover detectable in synovial fluid and blood. Rheumatology 31(9):583–591

42.

Tunç H, Öken Ö, Kara M, Tiftik T, Doǧu B, Ünlü Z, Özçakar L (2012) Ultrasonographic measurement of the femoral cartilage thickness in hemiparetic patients after stroke. Int J Rehabil Res 35(3):203–207PubMed

43.

Ulasli AM, Ozcakar L, Murrel WD (2019) Ultrasound imaging and guidance in the management of knee osteoarthritis in regenerative medicine field. J Clin Orthop Trauma 10(1):24–31PubMed

44.

Urquhart DM, Wluka AE, Teichtahl AJ, Cicuttini FM (2007) The effect of physical activity on the knee joint: is it good or bad? Br J Sports Med 41(9):546–547PubMedPubMedCentral

45.

van Melick N, Meddeler BM, Hoogeboom TJ, Nijhuis-van der Sanden MWG, van Cingel REH (2017) How to determine leg dominance: the agreement between self-reported and observed performance in healthy adults. PLoS ONE 12(12):e0189876PubMedPubMedCentral

46.

Vanwanseele B, Eckstein F, Knecht H, Spaepen A, Stüssi E (2003) Longitudinal analysis of cartilage atrophy in the knees of patients with spinal cord injury. Arthritis Rheum 48(12):3377–3381PubMed

47.

Xu C, Silder A, Zhang J, Reifman J, Unnikrishnan G (2017) A cross-sectional study of the effects of load carriage on running characteristics and tibial mechanical stress: implications for stress-fracture injuries in women. BMC Musculoskelet Disord 18(1):125PubMedPubMedCentral

Title: Mean femoral cartilage thickness is higher in athletes as compared with sedentary individuals
Authors: Naila Babayeva
Gürhan Dönmez
Levent Özçakar
Şerife Şeyma Torgutalp
Levend Karaçoban
Emre Gedik
Feza Korkusuz
Mahmut Nedim Doral
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2021
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-020-06146-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mean femoral cartilage thickness is higher in athletes as compared with sedentary individuals

Abstract

Purpose

Method

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

Level of evidence

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