Biochemical cartilage alteration and unexpected signal recovery in T2* mapping observed in ankle joints with mobile MRI during a transcontinental multistage footrace over 4486km

U. H.W. Schütz, J. Ellermann, D. Schoss, H. Wiedelbach, M. Beer, C. Billich

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Objective: The effect of ultra-long distance running on the ankle cartilage with regard to biochemical changes, thickness and lesions is examined in the progress of a transcontinental ultramarathon over 4486km. Method: In an observational field study, repeated follow-up scanning of 22 participants of the TransEurope FootRace (TEFR) with a 1.5T MRI mounted on a mobile unit was performed. For quantitative biochemical and structural evaluation of cartilage a fast low angle shot (FLASH) T2* weighted gradient-echo (GRE)-, a turbo-inversion-recovery-magnitude (TIRM)- and a fat-saturated proton density (PD)-weighted sequence were utilized. Statistical analysis of cartilage T2* and thickness changes was obtained on the 13 finishers (12 male, mean age 45.4 years, BMI 23.5kg/m2). None of the nine non-finisher (eight male, mean age 53.8 years, BMI 23.4kg/m2) stopped the race due to ankle problems. Results: From a mean of 17.0ms for tibial plafond and 18.0ms for talar dome articular cartilage at baseline, nearly all observed regions of interest (ROIs) of the ankle joint cartilage showed a significant T2*-signal increase (25.6% in mean), with standard error ranging from 19% to 33% within the first 2500km of the ultra-marathon. This initial signal behavior was followed by a signal decrease. This signal recovery (30.6% of initial increase) showed a large effect size. No significant morphological or cartilage thickness changes (at baseline 2.9mm) were observed. Conclusion: After initial T2*-increase during the first 2000-2500km, a subsequent T2*-decrease indicates the ability of the normal cartilage matrix to partially regenerate under ongoing multistage ultramarathon burden in the ankle joints.

Original languageEnglish (US)
Pages (from-to)1840-1850
Number of pages11
JournalOsteoarthritis and Cartilage
Volume22
Issue number11
DOIs
StatePublished - Nov 1 2014

Bibliographical note

Funding Information:
This work is supported in part by the German Research Association (DFG: “Deutsche Forschungsgemeinschaft”), under Grants SCHU 2514/1-1 and SCHU 2514/1-2 . The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.

Publisher Copyright:
© 2014 Osteoarthritis Research Society International.

Keywords

  • Ankle
  • Cartilage
  • Glycosaminoglycan
  • Marathon
  • Proteoglycan
  • Running

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