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The American Journal of Sports Medicine
Year: 2010  |  Volume: 38  |  Issue: 11  |  Page No.: 2273 - 2280

High-Field Magnetic Resonance Imaging Assessment of Articular Cartilage Before and After Marathon Running: Does Long-Distance Running Lead to Cartilage Damage?

A. C Luke, C Stehling, R Stahl, X Li, T Kay, S Takamoto, B Ma, S Majumdar and T. Link    

Abstract:

Background: There is continuing controversy whether long-distance running results in irreversible articular cartilage damage. New quantitative magnetic resonance imaging (MRI) techniques used at 3.0 T have been developed including T1rho (T1) and T2 relaxation time measurements that detect early cartilage proteoglycan and collagen breakdown.

Hypothesis: Marathon runners will demonstrate T1 and T2 changes in articular cartilage on MRI after a marathon, which are not seen in nonrunners. These changes are reversible.

Study Design: Cohort study; Level of evidence, 2.

Methods: Ten asymptomatic marathon runners had 3-T knee MRI scans 2 weeks before, within 48 hours after, and 10 to 12 weeks after running a marathon. The T1 and T2 MRI sequences in runners were compared with those of 10 age- and gender-matched controls who had MRI performed at baseline and 10 to 12 weeks.

Results: Runners did not demonstrate any gross morphologic MRI changes after running a marathon. Postmarathon studies, however, revealed significantly higher T2 and T1 values in all articular cartilage areas of the knee (P < .01) except the lateral compartment. The T2 values recovered to baseline except in the medial femoral condyle after 3 months. Average T1 values increased after the marathon from 37.0 to 38.9 (P < .001) and remained increased at 3 months.

Conclusion: Runners showed elevated T1 and T2 values after a marathon, suggesting biochemical changes in articular cartilage, T1 values remain elevated after 3 months of reduced activity. The patellofemoral joint and medial compartment of the knee show the highest signal changes, suggesting they are at higher risk for degeneration.

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