Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: A systematic review of randomised controlled trials

Alessio Bricca* (Corresponding Author), Carsten B. Juhl, Martijn Steultjens, Wolfgang Wirth, Ewa M. Roos

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Citations (Scopus)
7 Downloads (Pure)

Abstract

Objective: To investigate the impact of knee joint loading exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis (OA) by conducting a systematic review of randomised controlled trials (RCTs). Design: We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data sources: We performed a literature search with no restriction on publication year or language in MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials and Web of Science up to September 2017. Eligibility criteria: RCTs investigating the impact of exercise on MRI-assessed articular cartilage in people over 18 years of age. Results: We included nine trials, including a total of 14 comparisons of cartilage morphometry, morphology and composition outcomes, of which two included participants at increased risk of knee OA and 12 included participants with knee OA. In participants at increased risk, one study comparison reported no effect on cartilage defects and one had positive effects on glycosaminoglycans (GAG). In participants with OA, six study comparisons reported no effect on cartilage thickness, volume or defects; one reported a negative effect and one no effect on GAG; two reported a positive effect and two no effect on collagen. Conclusions: Knee joint loading exercise seems to not be harmful for articular cartilage in people at increased risk of, or with, knee OA. However, the quality of evidence was low, including some interventions studying activities considered outside the therapeutic loading spectrum to promote cartilage health.

Original languageEnglish
Pages (from-to)940-947
Number of pages8
JournalBritish Journal of Sports Medicine
Volume53
Issue number15
Early online date22 Jun 2018
DOIs
Publication statusPublished - 17 Jul 2019

Fingerprint

Knee Osteoarthritis
Articular Cartilage
Cartilage
Randomized Controlled Trials
Knee Joint
Glycosaminoglycans
Information Storage and Retrieval
MEDLINE
Osteoarthritis
Publications
Meta-Analysis
Language
Collagen
Guidelines
Health
Therapeutics

Keywords

  • cartilage
  • collagen
  • evidence based review
  • exercise
  • load

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis : A systematic review of randomised controlled trials. / Bricca, Alessio (Corresponding Author); Juhl, Carsten B.; Steultjens, Martijn; Wirth, Wolfgang; Roos, Ewa M.

In: British Journal of Sports Medicine, Vol. 53, No. 15, 17.07.2019, p. 940-947.

Research output: Contribution to journalArticle

Bricca, Alessio ; Juhl, Carsten B. ; Steultjens, Martijn ; Wirth, Wolfgang ; Roos, Ewa M. / Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis : A systematic review of randomised controlled trials. In: British Journal of Sports Medicine. 2019 ; Vol. 53, No. 15. pp. 940-947.
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abstract = "Objective: To investigate the impact of knee joint loading exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis (OA) by conducting a systematic review of randomised controlled trials (RCTs). Design: We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data sources: We performed a literature search with no restriction on publication year or language in MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials and Web of Science up to September 2017. Eligibility criteria: RCTs investigating the impact of exercise on MRI-assessed articular cartilage in people over 18 years of age. Results: We included nine trials, including a total of 14 comparisons of cartilage morphometry, morphology and composition outcomes, of which two included participants at increased risk of knee OA and 12 included participants with knee OA. In participants at increased risk, one study comparison reported no effect on cartilage defects and one had positive effects on glycosaminoglycans (GAG). In participants with OA, six study comparisons reported no effect on cartilage thickness, volume or defects; one reported a negative effect and one no effect on GAG; two reported a positive effect and two no effect on collagen. Conclusions: Knee joint loading exercise seems to not be harmful for articular cartilage in people at increased risk of, or with, knee OA. However, the quality of evidence was low, including some interventions studying activities considered outside the therapeutic loading spectrum to promote cartilage health.",
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