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| |  High Levels of Physical Activity Linked to Knee Damage: Presented at RSNA By Charlene Laino CHICAGO -- December 3, 2009 -- Patients with higher physical activity levels may be at greater risk for cartilage and meniscal abnormalities that may place them at higher risk of developing osteoarthritis, a study finds. Christoph Stehling, MD, University of California, San Francisco, San Francisco, California, and University of Muenster, Muenster, Germany, reported the findings here, on November 30, at the Radiological Society of North America (RSNA) 95th Annual Meeting. The study involved 136 women and 100 men, aged 45 to 55 years, with a body-mass index of 19 to 27. None had pain or other symptoms. Knee injuries were more common and more severe among those who engaged in the highest levels of physical activity, said Dr. Stehling. The participants were separated into low-, middle-, and high-activity groups based on their scores on the Physical Activity Scale for the Elderly (PASE), a well validated tool that “takes into account all physical activities, from running to yard work and washing the kitchen floor,” according to Dr. Stehling. The 68 participants with a PASE score of 27 to 144 comprised the low-activity group; the 122 participants with a score of 145 to 261 comprised the medium-activity group; and the 46 participants with a PASE score of 262 to 368 comprised the high-activity group. “A person whose activity level is classified as high typically might engage in several hours of walking, sports, or other types of exercise per week, as well as yard work and other household chores,” Dr. Stehling said. Magnetic resonance imaging (MRI) at 3.0 Tesla was performed on all participants using coronal intermediate-weighted 2-dimensional fast spin-echo, sagittal 3-dimensional dual-echo in steady state, and 2-dimensional intermediate-weighted fat-suppressed sequences of the right knee. All images were analysed by 2 musculoskeletal radiologists, who identified and graded cartilage, meniscal, ligamentous, and other knee abnormalities with whole-organ MRI (WORMS) scores. Meniscal lesions were found in 47% of the 236 subjects, cartilage lesions in 74.6%, bone marrow oedema pattern in 40.3%, and ligament lesions in 17%. Multivariate analysis adjusted for age, gender, and body-mass index showed that subjects in the high-activity arm had significantly more cartilage defects and other knee abnormalities than those in the low-activity group (P < .02). Among others findings: Also, cartilage damage was 3 times more severe in the high-activity group, Dr. Stehling said. Researchers aren’t sure that painless cartilage and bone damage can lead to osteoarthritis, but they think they do, says Joseph Tashjian, MD, St. Paul Radiology, St. Paul, Minnesota, who moderated a news conference about the findings. What is known, he said, is that high impact, weight-bearing activities, such as running and jumping, are worse for knee health and carry a greater risk of injury over time. The researchers are continuing to follow the participants to see if those in the high-activity group actually develop arthritis and if low-impact versus high-impact activities affect their risk. [Presentation title: Subjects With Higher Physical Activity Levels Have More Severe Focal Knee Lesions Diagnosed With 3T MRI: Analysis of the Non Symptomatic Incidence Cohort of the Osteoarthritis Initiative]
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