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Rheumatology Advance Access published online on July 18, 2008
Rheumatology, doi:10.1093/rheumatology/ken244
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The determinants of change in patella cartilage volume—a cohort study of healthy middle-aged women

S. P. Wijayaratne1,*, A. J. Teichtahl1,*, A. E. Wluka1,2, F. Hanna1, R. Bell3, S. R. Davis3, J. Adams3 and F. M. Cicuttini1

1Department of Epidemiology and Preventive Medicine, Monash University Medical School, Alfred Hospital, Prahran, 2Baker Heart Research Institute, Melbourne and 3The Women's; Health Program, Department of Medicine, Monash University Medical School, Alfred Hospital, Prahran, Victoria, Australia.

Correspondence to: F. M. Cicuttini, Department of Epidemiology and Preventive Medicine, Monash University Medical School, Alfred Hospital, Prahran, Victoria 3181, Australia. E-mail: flavia.cicuttini{at}med.monash.edu.au


  Abstract

Objectives. Although cartilage loss occurs with advancing age and is a hallmark of OA, the factors that affect cartilage change are not well established. The aim of this study was to explore the determinants of change in patella cartilage volume over 2 yrs among healthy middle-aged women with no clinical knee OA.

Methods. One hundred and forty-eight women with no clinical knee OA were recruited from a previous population-based cross-sectional study of healthy women aged 40–67 yrs. MRI was performed at baseline and at 2 yrs, to assess patella cartilage and bone volume. Self-reported exercise was assessed by questionnaire.

Results. Annual loss of patella cartilage volume was 1.6% (95% CI 1.2, 1.9). Age was positively associated with patella cartilage volume loss after adjustment for confounders (P = 0.05). For every 1 mm3 increase in patella bone volume at baseline, annual cartilage loss was reduced by 8.05 mm3 (95% CI 12.91, 3.19; P < 0.001). Fortnightly participation in exercise promoting an increased heart and respiratory rate for at least 20 min also tended to be associated with a reduced rate of patella cartilage volume loss (P = 0.09).

Conclusion. Among middle-aged women with no clinical knee OA, advancing age expedites the rate of patella cartilage volume loss, while increased patella bone volume and exercise participation tends to be associated with a reduction in the rate of patella cartilage volume loss. Interventions targeting modifiable factors, such as physical activity, warrant further investigation as they may help to prevent patellofemoral OA.

KEY WORDS: Patella, Cartilage, Bone, Osteoarthritis, Knee

*S. P. Wijayaratne and A. J. Teichtahl equally contributed to this work.

Submitted 2 January 2008; revised version accepted 5 June 2008.
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