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. 2013 Oct;65(10):2615-22.
doi: 10.1002/art.38062.

High body mass index is associated with increased diurnal strains in the articular cartilage of the knee

Margaret R Widmyer  1 , Gangadhar M Utturkar, Holly A Leddy, Jeremy L Coleman, Charles E Spritzer, Claude T Moorman 3rd, Louis E DeFrate, Farshid Guilak
Affiliations

High body mass index is associated with increased diurnal strains in the articular cartilage of the knee

Margaret R Widmyer et al. Arthritis Rheum. 2013 Oct.

Abstract

Objective: Obesity is an important risk factor for osteoarthritis (OA) and is associated with changes in both the biomechanical and inflammatory environments within the joint. However, the relationship between obesity and cartilage deformation is not fully understood. The goal of this study was to determine the effects of body mass index (BMI) on the magnitude of diurnal cartilage strain in the knee.

Methods: Three-dimensional maps of knee cartilage thickness were developed from 3T magnetic resonance images of the knees of asymptomatic age- and sex-matched subjects with normal BMI (18.5-24.9 kg/m2) or high BMI (25-31 kg/m2). Site-specific magnitudes of diurnal cartilage strain were determined using aligned images recorded at 8:00 AM and 4:00 PM on the same day.

Results: Subjects with high BMI had significantly thicker cartilage on both the patella and femoral groove, as compared to subjects with normal BMI. Diurnal cartilage strains were dependent on location in the knee joint, as well as BMI. Subjects with high BMI, compared to those with normal BMI, exhibited significantly higher compressive strains in the tibial cartilage. Cartilage thickness on both femoral condyles decreased significantly from the AM to the PM time point; however, there was no significant effect of BMI on diurnal cartilage strain in the femur.

Conclusion: Increased BMI is associated with increased diurnal strains in articular cartilage of both the medial and lateral compartments of the knee. The increased cartilage strains observed in individuals with high BMI may, in part, explain the elevated risk of OA associated with obesity or may reflect alterations in the cartilage mechanical properties in subjects with high BMI.

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Conflict of interest statement

The authors have no conflicts of interest to declare with regard to this research.

Figures

Figure 1
Figure 1
A. MR images were used to create 3D models of the knee, including the femur, tibia, patella, and the corresponding articular surfaces. B. A grid sampling system was used to characterize cartilage thickness and strain in different regions of the femur, tibia, and patella.
Figure 2
Figure 2
Representative cartilage thickness maps of the tibia from normal and high BMI individuals in the morning (AM) and evening (PM). Significant changes in cartilage thickness were observed in the cartilage of the tibial plateau between the AM and PM time points.
Figure 3
Figure 3
AM cartilage thickness of knee compartments varied significantly with location and BMI. Bars with different letters are significantly different from each other. All bars are mean±sem.
Figure 4
Figure 4
Measurements of cartilage thickness and strain in the patella. A. Cartilage thickness varied significantly with BMI, but did not vary from AM to PM. B. Cartilage strain was not significantly different from zero and did not vary with BMI. All bars are mean±sem.
Figure 5
Figure 5
Measurements of cartilage thickness and strain in the tibia. A. Medial tibia cartilage thickness decreased significantly from AM to PM and from normal to high BMI groups. Lateral tibial cartilage thickness decreased significantly from AM to PM. B. Medial tibial cartilage undergoes significant diurnal strain and compressive strain is significantly higher in the high BMI group. Lateral tibia cartilage from the high BMI group exhibited significant diurnal strain, and compressive strain was significantly higher in the high BMI group than in the normal BMI group. All bars are mean±sem. *Strain is significantly different from zero.
Figure 6
Figure 6
Measurements of cartilage thickness and strain on the femur. A. Cartilage thickness varied with BMI in the femoral groove and differed between AM and PM in the medial and lateral femoral condyles. B. The femoral groove did not undergo significant diurnal strain, whereas both the medial and lateral condyles did. No significant effect of BMI on diurnal cartilage strain was observed in any of the femoral locations. There was a significant effect of location on strain, with both condyles having greater compressive strain than the femoral groove. All bars are mean±sem. *Strain is significantly different from zero.
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