High-Field Magnetic Resonance Imaging Assessment of Articular Cartilage Before and After Marathon Running Does Long-Distance Running Lead to Cartilage Damage?

Background: There is continuing controversy whether long-distance running results in irreversible articular cartilage damage. New quantitative magnetic resonance imaging (MRI) techniques used at 3.0 T have been developed including T1rho (T1 rho) and T2 relaxation time measurements that detect early cartilage proteoglycan and collagen breakdown. Hypothesis: Marathon runners will demonstrate T1 rho and T2 changes in articular cartilage on MRI after a marathon, which are not seen in nonrunners. These changes are reversible. Study Design: Cohort study; Level of evidence, 2. Methods: Ten asymptomatic marathon runners had 3-T knee MRI scans 2 weeks before, within 48 hours after, and 10 to 12 weeks after running a marathon. The T1 rho and T2 MRI sequences in runners were compared with those of 10 age- and gender-matched controls who had MRI performed at baseline and 10 to 12 weeks. Results: Runners did not demonstrate any gross morphologic MRI changes after running a marathon. Postmarathon studies, however, revealed significantly higher T2 and T1r values in all articular cartilage areas of the knee (P < .01) except the lateral compartment. The T2 values recovered to baseline except in the medial femoral condyle after 3 months. Average T1 rho values increased after the marathon from 37.0 to 38.9 (P < .001) and remained increased at 3 months. Conclusion: Runners showed elevated T1 rho and T2 values after a marathon, suggesting biochemical changes in articular cartilage, T1 rho values remain elevated after 3 months of reduced activity. The patellofemoral joint and medial compartment of the knee show the highest signal changes, suggesting they are at higher risk for degeneration.