• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Johns Hopkins Arthritis Center

Show Search
Hide Search
  • Disease Information
    • Rheumatoid Arthritis
    • Psoriatic Arthritis
    • Ankylosing Spondylitis
    • Osteoarthritis
    • Gout
    • Osteoporosis
  • Patient Corner
    • Drug Information Sheets
    • Managing Your Arthritis
    • RheumTV – Patient Education Video Library
  • Our Research
    • Patient-Centered Outcomes Research
    • Current Research Studies
    • The Camille Julia Morgan Arthritis Research and Education Fund
  • About Us
    • Appointment Information
    • Contact Us
    • Our Faculty
    • Our Staff
    • Rheumatology Specialty Centers
  • Donate
Home / Arthritis News / Association Between Lower Extremity Muscle Mass and Knee Cartilage Volume

Association Between Lower Extremity Muscle Mass and Knee Cartilage Volume

March 22, 2005 By Arthritis Center

Increased body weight is thought to increase the risk of knee osteoarthritis (OA) by increasing the amount of mechanical knee loading subjected to the knees with use. Accordingly, obesity is a well-established risk factor for the development of knee OA. However, weight alone may not completely identify risk, as body weight reflects distribution of body composition (adipose, lean tissue mass, and bone mass) that may differ between individuals and convey differing risk patterns for knee OA. For example, decreased quadriceps muscle strength has also been shown to increase the risk of knee OA. Thus, while increased lower extremity muscle mass would add to overall body weight, the effect may actually be protective rather than detrimental to the knee. Here, Cicuttini et al (Arthritis Rheum 2005;52(2):461) examine the effect of patterns of body composition on the development of pathologic changes in knee cartilage volume that herald the development of knee OA.

Methods

Healthy men and women free of radiographic knee OA or recent knee pain were recruited through advertisements in newspapers, health clubs, and from hospital staff to undergo:

  1. Measures of body composition:
    1. Calculated body mass index (BMI)
    2. Quantification of total and regional body fat and lean tissue mass by total body DEXA scanning
  2. Quantification of knee cartilage volume of the dominant knee by MRI

A repeat knee MRI was obtained approximately 2 years after baseline MRI. The effect of baseline parameters of body composition on the change in medial- and lateral-tibial knee cartilage volume and on the rate of change in medial- and lateral-tibial knee cartilage volume at follow-up was determined with adjustment for potential confounding variables (age, gender, baseline BMI, medial/lateral tibial bone area, and physical activity).

Results

86 subjects (equally divided between men and women) underwent baseline evaluations and 70 (81%) of enrolled subjects underwent a follow-up assessment (mean 1.9 + 2.0 years after baseline). The mean age of participants was approximately 55 years with a mean BMI of approximately 26 kg/m2. Despite entry criteria excluding subjects with knee OA, 7 (8%) of enrolled subjects were designated as having knee OA at entry. While mean BMI was not significantly different between male and female participants, male subjects were generally heavier with higher mean muscle mass, lower mean fat mass, and larger mean knee cartilage volumes than female subjects.

Parameters of body composition with significant associations in multivariate models
Parameter Regression coefficient (95% CI) P value
Medial tibial cartilage volume at follow-up Total lower limb muscle mass 55.5 (21.7-87.2) 0.001
Total muscle mass in all limbs 46.1 (18.8-73.3) 0.001
Total body muscle mass 20.8 (6.6-35.0) 0.005
Change in medial-tibial cartilage volume Total lower limb muscle mass -46.5 (-68.8- -23.5) <0.001
Total muscle mass in all limbs -39.2 (-57.5- -21.0) <0.001
Total body muscle mass -16.8 (-25.5- -8.2) <0.001
Lateral-tibial cartilage volume at follow-up No significan associations — —
Change in lateral-tibial cartilage volume Total lower limb muscle mass -36.0 (-58.8- -13.3) 0.003
Total muscle mass in all limbs -29.4 (-47.7- -11.1) 0.002
Total body muscle mass -14.5 (-22.4- -6.7) 0.001

Other measures of body composition (BMI, total body fat mass, total lower limb fat mass, total fat mass in all limbs, and truncal fat mass) were not significantly associated with medial/lateral cartilage volume or change in medial/lateral cartilage volume in multivariate analysis.

Conclusions

Among healthy adults with a low prevalence of knee OA, increasing total and lower extremity muscle mass at baseline is associated with a greater medial (but not lateral) knee cartilage volume at follow-up. Increasing total and lower extremity muscle mass at baseline is also associated with a decreased rate of change in medial- and lateral-tibial cartilage volumes.

Editorial Comment

This study is one of the first to demonstrate strong associations between decreased total and lower extremity muscle mass and changes in knee cartilage that may lead to the development of knee OA. Importantly, neither BMI nor distributed body fat mass was found to be significantly associated with changes in knee cartilage volume. Although these findings suggest that interventions to increase total and lower extremity muscle mass before the development of knee OA might provide a protective effect, this study itself cannot provide proof of a causal relationship between reduced muscle mass and knee OA. However, these results do provide a foundation on which further controlled, interventional trials can be undertaken.

A notable strength of this study is the use of MRI for the measurement of knee cartilage volume. This imaging modality allows for accurate determinations of knee cartilage volumes while requiring fewer subjects and shorter follow-up than studies using measurements from plain radiographs as outcomes. However, these results make the assumption that declining knee cartilage volume in people without baseline knee OA predicts the development of knee OA. Although declining knee cartilage volume has been shown to be a strong predictor of disease progression in people with established OA, and it seems logical to assume that this is the same for people without OA, to date, this relationship has yet to be investigated.

Receive the Latest News from Johns Hopkins Rheumatology

Receive the Latest News from Johns Hopkins Rheumatology

Join our mailing list to receive the latest news and updates from Johns Hopkins Rheumatology.

Interested In

You have Successfully Subscribed!

Arthritis Center

Founded in 1998, the Arthritis Center at Johns Hopkins is dedicated to providing quality education to patients and healthcare providers alike.

Use of this Site

All information contained within the Johns Hopkins Arthritis Center website is intended for educational purposes only. Physicians and other health care professionals are encouraged to consult other sources and confirm the information contained within this site. Consumers should never disregard medical advice or delay in seeking it because of something they may have read on this website.

Primary Sidebar

Recent News

Exercise Tips for Arthritis Patients

How Does Exercise Affect my Joints? How Frequently Should I Be Exercising? Should I Lose Weight for Exercise to be

Risks and Benefits of Biologic Medications

Victoria Ruffing, RN, BC, Director of Patient Education at the Johns Hopkins Arthritis Center, shares the risks and benefits of biologic for

How to Manage Rheumatoid Arthritis Flares

Through research, doctors have a clearer understanding of how flares can impact a patient on a personal and emotional level. Dr. Uzma Haque

Complementary & Alternative Medicines for Psoriatic Arthritis

There are many complementary & alternative medicines and practices that have been found to be beneficial in curbing arthritis pain,

I can’t be a runner because I have Rheumatoid Arthritis (RA), right?

Dr. Manno discusses running and Rheumatoid Arthritis. Is it an option for the RA patient?

News Categories

  • Ankylosing Spondylitis News
  • Fibromyalgia News
  • Gout News
  • Lupus News
  • Osteoarthritis News
  • Osteoporosis News
  • Psoriatic Arthritis News
  • Rheumatoid Arthritis News
RheumTV Logo

Rheum.TV is an informational platform created to educate patients living with a rheumatic disease. With over 100 disease education videos produced by the team at Johns Hopkins Rheumatology.

Visit Rheum.TV

Footer

Johns Hopkins Rheumatology

  • Johns Hopkins Rheumatology
  • Johns Hopkins Lupus Center
  • Johns Hopkins Lyme Disease Research Center
  • Johns Hopkins Myositis Center
  • Johns Hopkins Scleroderma Center
  • Johns Hopkins Sjögren’s Syndrome Center
  • Johns Hopkins Vasculitis Center

Connect With Us

  • Facebook
  • Twitter
  • YouTube

Johns Hopkins Medicine

© 2023 Johns Hopkins Arthritis Center
Patient Privacy