Common Biochemical and Magnetic Resonance Imaging Biomarkers of Early Knee Osteoarthritis and of Exercise/Training in Athletes: A Narrative Review

Abstract

Knee osteoarthritis (OA) is the most common joint disease of the world population. Although considered a disease of old age, OA also affects young individuals and, more specifically among them, those practicing knee-joint-loading sports. Predicting OA at an early stage is crucial but remains a challenge. Biomarkers that can predict early OA development will help in the design of specific therapeutic strategies for individuals and, for athletes, to avoid adverse outcomes due to exercising/training regimens. This review summarizes and compares the current knowledge of fluid and magnetic resonance imaging (MRI) biomarkers common to early knee OA and exercise/training in athletes. A variety of fluid biochemical markers have been proposed to detect knee OA at an early stage; however, few have shown similar behavior between the two studied groups. Moreover, in endurance athletes, they are often contingent on the sport involved. MRI has also demonstrated its ability for early detection of joint structural alterations in both groups. It is currently suggested that for optimal forecasting of early knee structural alterations, both fluid and MRI biomarkers should be analyzed as a panel and/or combined, rather than individually.

New Horizons in Treatment of Knee Osteoarthritis: A Brief Look-up at Emerging Approaches

“…Scoring and manual, semi-automatic, and fully automated quantitative systems are among the MRI knee tissue evaluation methods. Despite low tissue contrast and radiation exposure, CT is a reliable bone assessment technology with quick scanning time and good spatial resolution [71,72]. New studies have shown that machine learning has the ability to automate the diagnosis and prognosis of KOA, leading to increased accuracy, efficiency, and repeatability.…”

“…With ongoing advancements in model development, this technology could lead to novel therapeutic options. [71,73,74].…”

Blood and urine biomarkers in osteoarthritis – an update on cartilage associated type II collagen and aggrecan markers

“…A long list of biomarkers has been tested in OA for different purposes and listed in several recent reviews [7][8][9]. For the purpose of a concise description, we will only describe type II collagen and aggrecan, which are the main components of cartilage although other proteins may be of equal interest.…”

Molecular Assessment of Healthy Pathological Articular Cartilages in Physically Active People: A Scoping Review

“…However, the myriad of markers discovered so far, whilst helpful for understanding certain aspects of cartilage pathophysiology, paradoxically have also contributed to diverting rather than guiding physiatrists and other therapists in defining qualitatively and quantitatively the best interventional approach. A reason could be that many of these putative cartilage biomarkers are not as specific indicators of cartilage health as they should be [ 27 ]. Another aspect to bear in mind is that, pre-clinical and/or in vitro studies assessing knee joint cartilage deformation may not have the expected translational value in humans [ 28 ], pinpointing the need for further in vivo experimentation in humans [ 16 ].…”