LISBON, Portugal — In a study conducted to better understand the impact of long-distance running on the knee in a large cohort of patients, investigators found the greatest effect on the patellofemoral joint cartilage in first-time marathon runners, followed by an increase in bone edema after study participants ran their first marathon.
Among 82 asymptomatic first-time marathoners, 164 knees were scanned with high-resolution 3.0 T MRI at 6 months prior to study participants training for their first marathon and then at 0.5 months after they ran the marathon. Change in radiographic scores of the knee structures as determined by two musculoskeletal radiologists was the primary outcome the investigators measured and change in participants’ self-reported KOOS score was the secondary outcome measure, both of which were determined before and after the marathon.
Laura-Maria Horga , of the general surgery research department at University College London, who presented the results at the EFORT Annual Congress, said, “We had a number of results from this study, but the key message is that different knee structures and compartments are affected differently by marathon running.”
For example, she said, “One of the key findings is that the patellofemoral compartment, most notably the cartilage, was most affected before and after the marathon. Secondly, the subchondral bone of the main weight-bearing compartments showed a beneficial effect of the marathon. Also, meniscal tears and bucket handle tears were found before and after the marathon, but did not worsen following the run.”
According to the results from Horga and her colleagues, KOOS scores changed significantly for the worse with regard to recreational activities and sports, as well as quality of life between the two time points when the scans and assessments were done. However, changes in the KOOS scores for daily activities, pain and symptoms were not statistically significant.
Looking at meniscal tears among the various knee structures the researchers studied, 36% of participants’ asymptomatic knees showed meniscal tears at the first time point.
“There were different types, such as there were horizontal tears, and also there were 58 of the bucket-handle tears before the marathon,” Horga said. “After the marathon, there was no change in the condition of meniscal tears.”
She showed an MRI of a bucket-handle tear, which remained the same after the marathon as it was before the run.
Horga said this study elucidates areas that can be focused on in injury prevention and exercise strategies for long-distance runners. – by Susan M. Rapp
Horga L-M, et al. Abstract 3089. Presented at: EFORT Annual Congress; June 5-7, 2019; Lisbon, Portugal.
Disclosure: Horga reports no relevant financial disclosures.