MR imaging of the knee in marathon runners before and after competition

Krampla, Wolfgang; Mayrhofer, R.; Malcher, J; Kristen, Karl-Heinz; Urban, Marie; Hruby, W

doi:10.1007/s002560000296

Cited by 93 publications

(92 citation statements)

References 4 publications

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“…There are only a few studies about acute lesions of the knee that occur after running a marathon and that are visible with MRI immediately after the running. To our knowledge, only two studies investigated changes in the menisci and ligaments of the knee and included only six and eight participants, respectively [2,6]. Thus, the question of whether or not or to what extent running a single marathon causes acute lesions of the knee has not been fully answered.…”

Section: Introductionmentioning

confidence: 99%

Does marathon running cause acute lesions of the knee? Evaluation with magnetic resonance imaging

et al. 2006

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An investigation was conducted into whether running a marathon causes acute alterations in menisci, cartilage, bone marrow, ligaments, or joint effusions, which could be evaluated by magnetic resonance imaging (MRI). Twenty-two non-professional marathon runners underwent MRI of the knee before and immediately after running a marathon. Lesions of menisci and cartilage (five-point scale), bone marrow, ligaments (three-point scale), joint effusion, and additional findings were evaluated and a total score was assessed. Before the marathon, grade 1 lesions of the menisci were found in eight runners, and grade 2 lesions in five runners. After the marathon, an upgrading from a meniscal lesion grade 1 to grade 2 was observed in one runner. Before the marathon, grade 1 cartilage lesions were found in three runners, and grade 2 lesions in one runner, all of which remained unchanged after the marathon. Before and after the marathon, unchanged bone marrow edema was present in three runners and unchanged anterior cruciate ligament lesions (grade 1) were seen in two runners. Joint effusions were present in 13 runners in the pre-run scans, slightly increased in four runners after the marathon, and newly occurred in one runner after the marathon. A total score comprising all knee lesions in each runner showed an increase after the marathon in two runners, whereas no runner showed an improvement of the radiological findings (Wilcoxon signed-rank test, P>0.05). The evaluation of lesions of the knee with MRI shows that marathon running does not cause severe, acute lesions of cartilage, ligaments, or bone marrow of the knee in well-trained runners. Only subtle changes, such as joint effusions or increased intrameniscal signal alterations, were imaged after running a marathon.

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Section: Introductionmentioning

confidence: 99%

Does marathon running cause acute lesions of the knee? Evaluation with magnetic resonance imaging

et al. 2006

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“…Beyond this degree of flexion, the limiting factor becomes the diameter of the scanner bore. In other studies where the aim was to image the knee in flexed position, only general-purpose surface coils have been used [46,47].…”

Section: Discussionmentioning

confidence: 99%

Kinematic biomechanical assessment of human articular cartilage transplants in the knee using 3-T MRI: an in vivo reproducibility study

et al. 2008

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The aims of this study were to examine the clinical feasibility and reproducibility of kinematic MR imaging with respect to changes in T (2) in the femoral condyle articular cartilage. We used a flexible knee coil, which allows acquisition of data in different positions from 40 degrees flexion to full extension during MR examinations. The reproducibility of T (2) measurements was evaluated for inter-rater and inter-individual variability and determined as a coefficient of variation (CV) for each volunteer and rater. Three different volunteers were measured twice and regions of interest (ROIs) were selected by three raters at different time points. To prove the clinical feasibility of this method, 20 subjects (10 patients and 10 age- and sex-matched volunteers) were enrolled in the study. Inter-rater variability ranged from 2 to 9 and from 2 to 10% in the deep and superficial zones, respectively. Mean inter-individual variability was 7% for both zones. Different T (2) values were observed in the superficial cartilage zone of patients compared with volunteers. Since repair tissue showed a different behavior in the contact zone compared with healthy cartilage, a possible marker for improved evaluation of repair tissue quality after matrix-associated autologous chondrocyte transplantation (MACT) may be available and may allow biomechanical assessment of cartilage transplants.

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“…Question 19 (internal validity on bias) was also scored poorly. All studies well addressed on questions 1-7 (reporting), 13 (external validity), [16][17][18]20 (internal validity on bias) and 26 (internal validity on confounding).…”

Section: Methodological Quality Assessmentmentioning

confidence: 99%

“…Numerous studies have employed MRI to examine pathological, morphological and/or biochemical changes in response to long-distance running, but such studies have mainly focused on the knee joint [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Many of these studies found significant changes including bone marrow edema (BME), joint effusion and cartilage thickness and volume, but such changes seem to return to baseline after a rest period (1 h to 8 weeks) [13,20,23].…”

Section: Introductionmentioning

confidence: 99%

“…Many of these studies found significant changes including bone marrow edema (BME), joint effusion and cartilage thickness and volume, but such changes seem to return to baseline after a rest period (1 h to 8 weeks) [13,20,23]. While the ankle and foot complex is one of the most common injured sites in response to long-distance running [24,25], there is no study systematically determining the effect of long-distance running on the ankle and foot.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of MR Images of the Ankle and Foot in Response to Long-Distance Running: A Systematic Review

Kim¹,

Fern²,

ez³

et al. 2017

Adv Tech Biol Med

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Background: It has remained controversial on whether excessive loadings imposed on the ankle and foot complex during long-distance running have a deleterious effect. The aim of this systematic review is to determine whether long-distance running causes any visible changes of the ankle and foot on magnetic resonance imaging (MRI).Methods: Scopus, Web of Science, Embase and Ovid Medline were searched using key terms in relation to MRI findings of the ankle and foot in response to long-distance running, published between 1990 and 2016. The final search was conducted on 19 September, 2016. Studies were identified using inclusion and exclusion criteria. Methodological quality was assessed using a modified Quality Index. Results:The database search initially produced 551 articles and it was screened based on inclusion and exclusion criteria, finally resulting in four articles. Edema was reported in the talus, tibia, calcaneus, navicular, cuboid and cuneiforms. A significant alteration in signal intensity and/or edema was appeared in the calcaneus at the Achilles insertion point, intraosseous and subcutaneous over long-distance running. The diameter of Achilles tendon was also significantly increased. However, when comparing between race finishers and non-finishers, the plantar aponeurosis and subcutaneous were only significantly different, reporting a high rate of edema in non-finishers. Additionally, one study adopted T2* mapping and found significant alteration in T2* values in tibiotalar cartilage, but the value was unexpectedly decreased in the middle of long-distance running. Conclusion:This is the first systematic review to determine the effect of long-distance running on the ankle and foot using MRI. It shows that long-distance running may cause subtle pathological and biochemical changes in the ankle and foot, including the talus, tibia, the distal and proximal group of tarsal bones, 5 th metatarsals, soft tissues and the Achilles tendons. However, there is no evidence that these changes have clinical relevance. Evaluation of MR

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MR imaging of the knee in marathon runners before and after competition

Abstract: In healthy individuals no negative long-term-effects were experienced. Pre-existing high-grade lesions of the menisci might be a predisposing risk for osteoarthritis, triggered by the stress of long-distance running.

Cited by 93 publications

References 4 publications

Does marathon running cause acute lesions of the knee? Evaluation with magnetic resonance imaging

Does marathon running cause acute lesions of the knee? Evaluation with magnetic resonance imaging

Kinematic biomechanical assessment of human articular cartilage transplants in the knee using 3-T MRI: an in vivo reproducibility study

Evaluation of MR Images of the Ankle and Foot in Response to Long-Distance Running: A Systematic Review

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