Contradictory evidences of sport activity on knee cartilage health and disease

Soccer players and athletes in high-impact sports including volley are frequently affected by knee injuries. Injuries to the anterior cruciate ligament and menisci are frequently observed in soccer players and may increase the risk of developing an articular cartilage lesion. In high-level athletes, the overall prevalence of knee articular cartilage lesions has been reported to be 36% to 38%. The treatment for athletic patients with articular cartilage lesions is often challenging because of the high demands placed on the repair tissue by impact sports. The early diagnosis and treatment of cartilage and associate injuries is a key element to allow for a return to sports after injury in athletes. Besides the reconstruction of ligaments and menisci, addressing the cartilage lesions seems to be the most crucial point in avoiding the progression of a sustained cartilage defect to osteoarthritis that, in the past, was observed to become radiographically evident in the 57% of the athletes after 14 years after the initial injury. Contradictory evidences regarding middle- aged, non-professional marathon runners have been recently published by the British Medical Journal. Premarathon and pretraining MRI showed signs of damage, without symptoms, to several knee structures in the majority of the middle-aged recruited runners. However, after the marathon, MRI showed a reduction in the radiological score of damage in: subchondral bone marrow oedema in the condyles of the tibia and femur. MRI did also show an increase in radiological scores to the following structures: cartilage of the lateral patella; semimembranosus tendon; iliotibial band and the prepatellar bursa. The Authors conclude that in novice runners the damaged subchondral bone of the tibial and femoral condyles can be improved by long distance running while the patella cartilage undergoes to worsening although asymptomatic.

References:

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Horga LM, Henckel J, Fotiadou A, Hirschmann A, Torlasco C, Di Laura A, D’Silva A, Sharma S, Moon J, Hart A. Can marathon running improve knee damage of middle-aged adults? A prospective cohort study. BMJ Open Sport Exerc Med. 2019 Oct 16;5(1):e000586. doi: 10.1136/bmjsem-2019-000586