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Arthritis & Rheumatism

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Volume 52, Issue 11 , Pages 3507 - 3514

Published Online: 28 Oct 2005

Copyright © 2005 by the American College of Rheumatology

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 Research Article
Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: A four-month, randomized, controlled trial in patients at risk of osteoarthritis
Ewa M. Roos 1, Leif Dahlberg 2 *
1Lund University, Lund, Sweden
2Malmö University Hospital, Malmo, Sweden
email: Leif Dahlberg (leif.dahlberg@med.lu.se.)

*Correspondence to Leif Dahlberg, Department of Orthopedics, Malmö University Hospital, SE-205 02 Malmo, Sweden

Funded by:
 Swedish Research Council
 Swedish National Centre for Research in Sports
 Knut and Alice Wallenberg Foundation
 Zoega Medical Foundation
 Swedish Rheumatism Association
 Lund Medical Faculty
 Malmö University Hospital


To evaluate the effects of moderate exercise on glycosaminoglycan (GAG) content in knee cartilage in subjects at high risk of knee osteoarthritis (OA).

Forty-five subjects (16 women, mean age 46 years, mean body mass index 26.6 kg/m2) who underwent partial medial meniscus resection 3-5 years previously were randomized to undergo a regimen of supervised exercise 3 times weekly for 4 months or to a nonintervention control group. Cartilage GAG content, an important aspect of the biomechanical properties of cartilage, was estimated by delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), with results expressed as the change in the T1 relaxation time in the presence of Gd-DTPA (T1[Gd]).

Thirty of 45 patients were examined by dGEMRIC at baseline and followup. The exercise group (n = 16) showed an improvement in the T1(Gd) compared with the control group (n = 14) (15 msec versus -15 msec; P = 0.036). To study the dose response, change in the T1(Gd) was assessed for correlation with self-reported change in physical activity level, and a strong correlation was found in the exercise group (n = 16, rS = 0.70, 95% confidence interval [95% CI] 0.31-0.89) and in the pooled group of all subjects (n = 30, rS = 0.74, 95% CI 0.52-0.87).

This in vivo cartilage monitoring study in patients at risk of knee OA who begin exercising indicates that adult human articular cartilage has a potential to adapt to loading change. Moderate exercise may be a good treatment not only to improve joint symptoms and function, but also to improve the knee cartilage GAG content in patients at high risk of developing OA.

Received: 10 February 2005; Accepted: 12 August 2005

Digital Object Identifier (DOI)

10.1002/art.21415  About DOI

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