Knee cartilage of spinal cord–injured patients displays progressive thinning in the absence of normal joint loading and movement
Article first published online: 9 AUG 2002
Copyright © 2002 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 46, Issue 8, pages 2073–2078, August 2002
How to Cite
Vanwanseele, B., Eckstein, F., Knecht, H., Stüssi, E. and Spaepen, A. (2002), Knee cartilage of spinal cord–injured patients displays progressive thinning in the absence of normal joint loading and movement. Arthritis & Rheumatism, 46: 2073–2078. doi: 10.1002/art.10462
- Issue published online: 9 AUG 2002
- Article first published online: 9 AUG 2002
- Manuscript Accepted: 30 APR 2002
- Manuscript Received: 22 JAN 2002
- Swiss Paraplegic Foundation
Alterations in the morphologic, biochemical, and mechanical properties of cartilage occur after unloading and immobilization in animals. However, the findings have been inconsistent and it is unclear whether such changes also take place in humans. This study tested the hypothesis that progressive thinning of knee joint cartilage is observed after spinal cord injury.
In this in vivo study, knee cartilage was assessed in patients with complete, traumatic spinal cord injury at 6 (n = 9), 12 (n = 11), and 24 months (n = 6) after injury. Morphologic parameters of the knee cartilage (mean and maximum thickness as well as surface area) were computed from magnetic resonance imaging (MRI) data, and results were compared with those in young, healthy volunteers (n = 9).
After 6 months of injury, the mean articular-cartilage thickness was significantly less in the patella and medial tibia (decrease of 10% and 16%, respectively; P < 0.05), but not in the lateral tibia (decrease of 10%), compared with the MRI findings in healthy volunteers. After 12 and 24 months of injury, the differences amounted to a reduction of 21% and 23%, respectively, in the patella, 24% and 25%, respectively, in the medial tibia, and 16% and 19%, respectively, in the lateral tibia. The changes were significant in all 3 surfaces of the spinal cord–injured joint cartilage (P < 0.05–0.01).
Our data show, for the first time, that progressive thinning (atrophy) of human cartilage occurs in the absence of normal joint loading and movement. This may have important implications for patient management, in particular for spinal cord–injured patients and patients who are immobilized after surgery.