Document Detail


Change in knee cartilage volume in individuals completing a therapeutic exercise program for knee osteoarthritis.
MedLine Citation:
PMID:  21891881     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Prospective cohort study.
OBJECTIVES: To characterize knee cartilage change in individuals with knee osteoarthritis (KOA) who have completed a therapeutic exercise program.
BACKGROUND: While therapeutic exercise is frequently used successfully to improve pain and function in individuals with KOA, no studies have reported the volume of cartilage change or individual factors that may impact volume of cartilage change in those completing an exercise program for KOA.
METHODS: Thirteen individuals with KOA underwent magnetic resonance imaging to quantify cartilage volume change in the weight-bearing regions of the medial and lateral femoral condyles and the entire surface of the tibial plateaus from baseline to 1-year follow-up. Body structure and function measures were taken for body mass index, knee axis alignment, knee motion, and knee strength. Activity limitations and activity levels were also measured prior to the therapeutic exercise program, using the Western Ontario and McMaster Universities Osteoarthritis Index and the Physical Activity Scale for the Elderly. At 6 months from baseline, follow-up clinical measurements of knee strength and motion were performed. At 1 year from baseline, imaging of the knee cartilage and knee alignment were performed, and participants completed the Western Ontario and McMaster Universities Osteoarthritis Index and Physical Activity Scale for the Elderly.
RESULTS: The central region of the medial femoral condyle (cMF) had a median volume of cartilage loss of 3.8%. The other 3 knee tibiofemoral articular surfaces had minimal median cartilage volume change. Individuals were dichotomized into progressors (n = 6) and nonprogressors (n = 7), based on the standard error of measurement of cartilage volume change for the cMF. Progressors were younger, had a larger body mass index, had a higher Kellgren-Lawrence grade in the medial compartment of the knee, and had a greater increase in knee varus alignment from baseline to 1-year follow-up. The progressors also had frontal plane hip and knee kinetics during baseline gait analysis that potentially increased medial knee joint loading.
CONCLUSION: The loss of cMF cartilage volume was highly variable and the median loss of cartilage was within the range previously reported. Seven of the 13 individuals did not have cMF cartilage volume loss greater than the standard error of measurement. Change in cartilage volume of the cMF may be influenced to a greater extent by personal factors than by completion of a therapeutic exercise program. Additional research is needed to decipher the interactions among therapeutic exercise and personal characteristics that impact knee cartilage loss.
Authors:
Jason D Woollard; Alexandra B Gil; Patrick Sparto; C Kent Kwoh; Sara R Piva; Shawn Farrokhi; Christopher M Powers; G Kelley Fitzgerald
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-09-04
Journal Detail:
Title:  The Journal of orthopaedic and sports physical therapy     Volume:  41     ISSN:  1938-1344     ISO Abbreviation:  J Orthop Sports Phys Ther     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-07     Completed Date:  2012-02-21     Revised Date:  2013-11-07    
Medline Journal Info:
Nlm Unique ID:  7908150     Medline TA:  J Orthop Sports Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  708-22     Citation Subset:  IM    
Affiliation:
Department of Physical Therapy, Chatham University, Pittsburgh, PA 15232, USA. JWoollard@chatham.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Biomechanics
Cartilage / growth & development*
Cohort Studies
Exercise Therapy*
Female
Humans
Knee Joint / physiopathology*
Magnetic Resonance Imaging
Male
Middle Aged
Osteoarthritis, Knee / therapy*
Prospective Studies
United States
Grant Support
ID/Acronym/Agency:
1-R01-AR048760/AR/NIAMS NIH HHS; P30 AG024827/AG/NIA NIH HHS; R01 AR048760/AR/NIAMS NIH HHS; UL1 RR024153/RR/NCRR NIH HHS; UL1 TR000005/TR/NCATS NIH HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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