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Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis : A systematic review of randomised controlled trials

Published on Jun 22, 2018in British Journal of Sports Medicine 11.64
· DOI :10.1136/bjsports-2017-098661
Alessio Bricca2
Estimated H-index: 2
,
Carsten Bogh Juhl15
Estimated H-index: 15
(UCPH: University of Copenhagen)
+ 2 AuthorsEwa M. Roos63
Estimated H-index: 63
Cite
Abstract
Objective To investigate the impact of knee joint loading exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis (OA) by conducting a systematic review of randomised controlled trials (RCTs). Design We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data sources We performed a literature search with no restriction on publication year or language in MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials and Web of Science up to September 2017. Eligibility criteria RCTs investigating the impact of exercise on MRI-assessed articular cartilage in people over 18 years of age. Results We included nine trials, including a total of 14 comparisons of cartilage morphometry, morphology and composition outcomes, of which two included participants at increased risk of knee OA and 12 included participants with knee OA. In participants at increased risk, one study comparison reported no effect on cartilage defects and one had positive effects on glycosaminoglycans (GAG). In participants with OA, six study comparisons reported no effect on cartilage thickness, volume or defects; one reported a negative effect and one no effect on GAG; two reported a positive effect and two no effect on collagen. Conclusions Knee joint loading exercise seems to not be harmful for articular cartilage in people at increased risk of, or with, knee OA. However, the quality of evidence was low, including some interventions studying activities considered outside the therapeutic loading spectrum to promote cartilage health.
  • References (48)
  • Citations (9)
Cite
References48
Newest
Published on May 1, 2018in British Journal of Sports Medicine 11.64
Gwen Sascha Fernandes5
Estimated H-index: 5
,
Sanjay Mukund Parekh1
Estimated H-index: 1
(Arthritis Research UK)
+ 5 AuthorsMichael Doherty74
Estimated H-index: 74
Objectives To determine the prevalence of knee pain, radiographic knee osteoarthritis (RKOA), total knee replacement (TKR) and associated risk factors in male ex-professional footballers compared with men in the general population (comparison group). Methods 1207 male ex-footballers and 4085 men in the general population in the UK were assessed by postal questionnaire. Current knee pain was defined as pain in or around the knees on most days of the previous month. Presence and severity of RKOA w...
Ian J. Wallace13
Estimated H-index: 13
(Harvard University),
Steven Worthington6
Estimated H-index: 6
(Harvard University)
+ 5 AuthorsDaniel E. Lieberman58
Estimated H-index: 58
(Harvard University)
Knee osteoarthritis (OA) is believed to be highly prevalent today because of recent increases in life expectancy and body mass index (BMI), but this assumption has not been tested using long-term historical or evolutionary data. We analyzed long-term trends in knee OA prevalence in the United States using cadaver-derived skeletons of people aged ≥50 y whose BMI at death was documented and who lived during the early industrial era (1800s to early 1900s; n = 1,581) and the modern postindustrial er...
Published on Jul 1, 2017in Medicine and Science in Sports and Exercise 4.48
Matti Munukka4
Estimated H-index: 4
,
Benjamin Waller9
Estimated H-index: 9
+ 7 AuthorsAri Heinonen54
Estimated H-index: 54
ABSTRACTPurposeTo study the relationship between 12-month leisure-time physical activity (LTPA) level and changes in estimated biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA).MethodsOriginally, 87 volunteer postmenopausal women, age 60 to
Published on Apr 1, 2017in The Journal of Rheumatology 3.63
Adam El Mongy Jørgensen1
Estimated H-index: 1
(UCPH: University of Copenhagen),
Michael Kjaer90
Estimated H-index: 90
,
Katja M. Heinemeier24
Estimated H-index: 24
Objective The morphology of articular cartilage (AC) enables painless movement. Aging and mechanical loading are believed to influence development of osteoarthritis (OA), yet the connection remains unclear. Methods This narrative review describes the current knowledge regarding this area, with the literature search made on PubMed using appropriate keywords regarding AC, age, and mechanical loading. Results Following skeletal maturation, chondrocyte numbers decline while increasing senescence occ...
Published on Jan 26, 2017in International Journal of Molecular Sciences 4.18
Hirotaka Mutsuzaki11
Estimated H-index: 11
,
Hiromi Nakajima8
Estimated H-index: 8
+ 2 AuthorsMasataka Sakane26
Estimated H-index: 26
This study examined the influence of immobilization on chondrocyte apoptosis and histological features of the anterior cruciate ligament (ACL) insertion and knee articular cartilage in rabbits. Forty-eight male Japanese white rabbits were assigned to an immobilization (n = 24) or sham (n = 24) group. Rabbits in the immobilization group underwent complete unilateral surgical knee immobilization and rabbits in the sham group underwent a sham surgery. The average thickness of the glycosaminoglycan ...
Published on Oct 1, 2016in Nature Reviews Rheumatology 18.55
William A. Robinson76
Estimated H-index: 76
,
Christin M. Lepus9
Estimated H-index: 9
(Stanford University)
+ 4 AuthorsJeremy Sokolove26
Estimated H-index: 26
Emerging evidence indicates that the inflammatory mechanisms involved in the pathophysiology of osteoarthritis (OA) differ from those in rheumatoid arthritis. This Review explores the mechanisms of chronic, low-grade inflammation in OA, discusses the evidence of their central role in its pathogenesis, and explores how they might be targeted to prevent or treat OA.
Published on Oct 1, 2016in Osteoarthritis and Cartilage 4.88
Matti Munukka4
Estimated H-index: 4
(University of Jyväskylä),
Benjamin Waller9
Estimated H-index: 9
(University of Jyväskylä)
+ 11 AuthorsA. Peuna1
Estimated H-index: 1
(University of Oulu)
Summary Objective To study the efficacy of aquatic resistance training on biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA). Design Eighty seven volunteer postmenopausal women, aged 60–68 years, with mild knee OA (Kellgren–Lawrence grades I/II and knee pain) were recruited and randomly assigned to an intervention ( n = 43) and control ( n = 44) group. The intervention group participated in 48 supervised aquatic resistance training sessio...
Published on Sep 1, 2016in Osteoarthritis and Cartilage 4.88
Jean-Hugues Salmon3
Estimated H-index: 3
(URCA: University of Reims Champagne-Ardenne),
Anne-Christine Rat17
Estimated H-index: 17
(Paris V: Paris Descartes University)
+ 5 AuthorsB. Fautrel25
Estimated H-index: 25
(UPMC: Pierre-and-Marie-Curie University)
Objective An overview of the economic consequences – overall costs as well as cost breakdown (direct and indirect) – of hip and knee osteoarthritis (OA) worldwide. Methods A systematic literature search of EMBASE, MEDLINE, Scopus and Cochrane databases for articles was performed independently by two rheumatologists who used the same predefined eligible criteria. Papers without abstracts and in languages other than English or French were excluded. Extracted costs were converted to an annual cost ...
Published on Jun 1, 2016in Osteoarthritis and Cartilage 4.88
M.L. Landsmeer2
Estimated H-index: 2
(EUR: Erasmus University Rotterdam),
J. Runhaar11
Estimated H-index: 11
(EUR: Erasmus University Rotterdam)
+ 6 AuthorsSita M. A. Bierma-Zeinstra68
Estimated H-index: 68
(EUR: Erasmus University Rotterdam)
Summary Objective To evaluate the preventive effects of a randomized controlled trial on progression of Magnetic Resonance Imaging (MRI) features of knee osteoarthritis (OA) in overweight and obese women. Design In a 2 × 2 factorial design, 2.5 years effects of a diet and exercise program and of glucosamine sulphate (double-blind, placebo-controlled) were evaluated in 407 middle-aged women with body mass index (BMI) ≥ 27 kg/m 2 without clinical signs of knee OA at baseline (ISRCTN 42823086). MRI...
Cited By9
Newest
Published in Knee 1.76
Jean-Francois Esculier2
Estimated H-index: 2
,
Michael Jarrett3
Estimated H-index: 3
+ -3 AuthorsMichael A. Hunt33
Estimated H-index: 33
Published on Mar 25, 2019in Rheumatology International 2.20
Optimal management of knee osteoarthritis (KOA) should include, where possible, modification of risk factors through targeted interventions. The objectives of the present narrative review were to identify, summarize, and cluster all the potentially modifiable risk factors that influence the course of KOA, and discuss their susceptibility to alteration via personal, clinical, and public strategy. For this purpose, Pubmed and Scopus databases were queried using the terms “knee osteoarthritis”, “ri...
Published on Jun 21, 2019in British Journal of Sports Medicine 11.64
Alessio Bricca2
Estimated H-index: 2
,
Ewa M. Roos63
Estimated H-index: 63
(University of Southern Denmark)
+ 3 AuthorsC. J. Barton28
Estimated H-index: 28
OA is a leading cause of disability worldwide and associated with pain, impaired mobility and quality of life.1 Physical activity, including therapeutic exercise, patient education and weight control are recommended in key OA treatment guidelines.2 Nevertheless, the belief that therapeutic exercise may harm knee joint cartilage remains common among people with knee OA, and health professionals treating the condition, creating a prevailing barrier to implementing evidence-based care.3–5 The curre...
Published on Jun 1, 2019in Seminars in Arthritis and Rheumatism 5.07
Ans Van Ginckel10
Estimated H-index: 10
(UGent: Ghent University),
Michelle Hall9
Estimated H-index: 9
(University of Melbourne)
+ 1 AuthorsPatrick Calders26
Estimated H-index: 26
(UGent: Ghent University)
Abstract Objective To investigate effects of long-term exercise therapy for people with knee osteoarthritis (OA) on radiographic disease severity and cartilage integrity (primary outcomes) as well as severity of bone marrow lesions (BMLs), synovitis and/or effusion (secondary outcomes). Methods We sourced randomized controlled trials in people with clinical and/or radiographic OA investigating the effect of land-based exercise therapy of > 6 months on radiographic disease severity and magnetic r...
Published on Mar 4, 2019in Physical Therapy Reviews
Sophie Ruth Allen (Curtin University), Anthony Wright21
Estimated H-index: 21
(Curtin University)
AbstractBackground: Stem cell therapy has emerged as a new, exciting treatment for repair of articular cartilage in osteoarthritis (OA), which currently has no cure. Regenerative cell therapies can potentially offer alternatives to total joint replacement for patients with OA. A variety of cell-based therapies have been developed involving the use of autologous and allogeneic mesenchymal stem cells (MSCs). To date, these stem cell therapies have been shown to be safe and efficacious, but informa...
Published on Mar 1, 2019in Revista Brasileira De Fisioterapia
Robin M. Daly39
Estimated H-index: 39
(Deakin University),
Jack Dalla Via1
Estimated H-index: 1
(Deakin University)
+ 2 AuthorsEva Wulff Helge12
Estimated H-index: 12
(UCPH: University of Copenhagen)
Abstract Background Osteoporosis and related fragility fractures are a global public health problem in which pharmaceutical agents targeting bone mineral density (BMD) are the first line of treatment. However, pharmaceuticals have no effect on improving other key fracture risk factors, including low muscle strength, power and functional capacity, all of which are associated with an increased risk for falls and fracture, independent of BMD. Targeted exercise training is the only strategy that can...
Published on Feb 1, 2019in Arthritis Care and Research 4.53
Alessio Bricca2
Estimated H-index: 2
(University of Southern Denmark),
W. Wirth33
Estimated H-index: 33
+ 5 AuthorsAdam G Culvenor12
Estimated H-index: 12
(La Trobe University)
Published on Dec 1, 2018in British Journal of Sports Medicine 11.64
Alessio Bricca2
Estimated H-index: 2
I investigated the impact of exercise on knee joint articular cartilage. This aim was investigated in three different systematic reviews (SRs) of randomised controlled trials (RCTs) in healthy animals and in humans at risk of or with knee osteoarthritis (OA). Exercise is the first-line treatment for knee OA.1 Yet, many people still believe that exercise may ‘ wear down my knee ’ creating a barrier to exercise. Articular cartilage is the hallmark of OA and the structure I studied in my PhD. It is...
Corey S. Cook1
Estimated H-index: 1
,
Patrick A. Smith11
Estimated H-index: 11
(MU: University of Missouri)
Purpose of Review The purpose of this review is to update the reader on the current applications of platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA). This review will focus on PRP’s effect on the osteoarthritic joint, how PRP compares to traditional treatments of KOA, and provide clinical feedback on the use of PRP in an orthopedic and sports medicine practice.
Published on Oct 1, 2018in PLOS ONE 2.78
Jean-Francois Esculier2
Estimated H-index: 2
(UBC: University of British Columbia),
Natasha M. Krowchuk6
Estimated H-index: 6
(UBC: University of British Columbia)
+ 2 AuthorsMichael A. Hunt33
Estimated H-index: 33
(UBC: University of British Columbia)
Objectives To evaluate the perceptions of the general public and healthcare practitioners (HCP) in Canada about the relationship between running and knee joint health, and to explore HCP`s usual recommendations to runners with knee osteoarthritis (KOA). Methods Non-runners and runners (with and without KOA) and HCP completed an online survey regarding the safety of running for knee joint health. HCP also provided information related to usual clinical recommendations. Proportions of agreement wer...