Exercise May Improve Knee Cartilage in Patients at Risk for [Osteoarthritis]
Author: Laurie Barclay, MD.
From: Medscape
Oct. 28, 2005 — Exercise improves the glycosaminoglycan (GAG) content of the knee in patients at risk for osteoarthritis (OA), according to the results of a randomized trial reported in the November issue of Arthritis & Rheumatism.
"The effects of exercise on human cartilage are largely unknown because, until recently, investigators have been unable to examine the biochemical properties of cartilage tissue in vivo," write Ewa M. Roos, MD, and Leif Dahlberg, MD, from the Lund University and Malmo University Hospital in Sweden. "Delayed gadolinium-enhanced MRI [magnetic resonance imaging] of cartilage (dGEMRIC) estimates cartilage quality by measuring the fixed-charge density of tissue, comprising GAGs. GAGs are building blocks of proteoglycans and are crucial for the important viscoelastic properties of cartilage.
In this study, 45 subjects who underwent partial medial meniscus resection three to five years previously were randomized to supervised exercise three times weekly for four months or to a nonintervention control group. There were 16 women and 29 men; mean age was 46 years, and mean body mass index was 26.6 kg per m2. Cartilage GAG content was estimated using dGEMRIC, with results expressed as the change in T1(Gd) relaxation time.
Of the 45 subjects, 30 had dGEMRIC both at baseline and follow-up. Compared with the control group (n = 14), the exercise group (n = 16) had an improvement in the T1(Gd) (15 vs -15 millisecond; P = .036). To determine the dose response, the investigators examined the correlation between change in the T1(Gd) and self-reported change in physical activity level. There was a strong correlation in the exercise group (n = 16; rS = 0.70; 95% confidence interval [CI], 0.31 - 0.89) and in the pooled group of all subjects (n = 30; rS = 0.74; 95% CI, 0.52 - 0.87).
"This in vivo cartilage monitoring study in patients at risk of knee OA who begin exercising indicates that adult human articular cartilage has a potential to adapt to loading change," the authors write. "Moderate exercise may be a good treatment not only to improve joint symptoms and function, but also to improve the knee cartilage GAG content in patients at high risk of developing OA."
Study limitations include limited applicability to other groups at risk for OA, loss to follow-up, methodologic issues related to dGEMRIC, clinical significance of the results, and short follow-up time.
"Moderate, supervised exercise improves knee-cartilage GAG content in patients at risk of OA," the authors conclude. "Exercise may have important implications for disease prevention in patients at risk of developing knee OA."
The Swedish Research Council, the Swedish National Centre for Research in Sports, the Knut and Alice Wallenberg Foundation, the Zoega Medical Foundation, the Swedish Rheumatism Association, Lund Medical Faculty, and Malmö University Hospital have disclosed that they supported this study.
"The effects of exercise on human cartilage are largely unknown because, until recently, investigators have been unable to examine the biochemical properties of cartilage tissue in vivo," write Ewa M. Roos, MD, and Leif Dahlberg, MD, from the Lund University and Malmo University Hospital in Sweden. "Delayed gadolinium-enhanced MRI [magnetic resonance imaging] of cartilage (dGEMRIC) estimates cartilage quality by measuring the fixed-charge density of tissue, comprising GAGs. GAGs are building blocks of proteoglycans and are crucial for the important viscoelastic properties of cartilage.
In this study, 45 subjects who underwent partial medial meniscus resection three to five years previously were randomized to supervised exercise three times weekly for four months or to a nonintervention control group. There were 16 women and 29 men; mean age was 46 years, and mean body mass index was 26.6 kg per m2. Cartilage GAG content was estimated using dGEMRIC, with results expressed as the change in T1(Gd) relaxation time.
Of the 45 subjects, 30 had dGEMRIC both at baseline and follow-up. Compared with the control group (n = 14), the exercise group (n = 16) had an improvement in the T1(Gd) (15 vs -15 millisecond; P = .036). To determine the dose response, the investigators examined the correlation between change in the T1(Gd) and self-reported change in physical activity level. There was a strong correlation in the exercise group (n = 16; rS = 0.70; 95% confidence interval [CI], 0.31 - 0.89) and in the pooled group of all subjects (n = 30; rS = 0.74; 95% CI, 0.52 - 0.87).
"This in vivo cartilage monitoring study in patients at risk of knee OA who begin exercising indicates that adult human articular cartilage has a potential to adapt to loading change," the authors write. "Moderate exercise may be a good treatment not only to improve joint symptoms and function, but also to improve the knee cartilage GAG content in patients at high risk of developing OA."
Study limitations include limited applicability to other groups at risk for OA, loss to follow-up, methodologic issues related to dGEMRIC, clinical significance of the results, and short follow-up time.
"Moderate, supervised exercise improves knee-cartilage GAG content in patients at risk of OA," the authors conclude. "Exercise may have important implications for disease prevention in patients at risk of developing knee OA."
The Swedish Research Council, the Swedish National Centre for Research in Sports, the Knut and Alice Wallenberg Foundation, the Zoega Medical Foundation, the Swedish Rheumatism Association, Lund Medical Faculty, and Malmö University Hospital have disclosed that they supported this study.
Arthritis Rheum. 2005;52:3507-3514
posted by Ricardo Pocurull at 10:59 AM
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