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Factors influencing longitudinal change in knee cartilage volume measured from magnetic resonance imaging in healthy men
  1. F Hanna1,
  2. P R Ebeling3,
  3. Y Wang4,
  4. R O’Sullivan5,
  5. S Davis2,
  6. A E Wluka1,
  7. F M Cicuttini1
  1. 1Department of Epidemiology and Preventive Medicine, Monash University Medical School, Alfred Hospital, Melbourne, Victoria, Australia
  2. 2NHMRC Centre for Clinical Research Excellence for Women’s Health Programme, Department of Medicine, Monash University Victoria, Australia
  3. 3Department of Medicine and Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia
  4. 4Graduate School of Integrative Medicine, Swinburne University of Technology, Hawthorn, Victoria, Australia
  5. 5MRI Unit, Mayne Health Diagnostic Imaging Group, Epworth Hospital, Richmond, Victoria, Australia
  1. Correspondence to:
    Associate Professor Flavia Cicuttini
    Department of Epidemiology and Preventive Medicine, Monash University – Central and Eastern Clinical School, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia;


Objective: To determine whether the amount of joint cartilage in healthy, middle aged men is stable or changes over time, and what factors may influence this.

Methods: In a cohort study, 28 healthy men (70% of the original cohort; mean (SD) age, 51.9 (12.8) years) had baseline knee magnetic resonance imaging (MRI) of their dominant knee and repeat MRI of the same knee approximately 2.0 years later. Knee cartilage volume was measured at baseline and follow up. Risk factors assessed at baseline, including sex hormones and metabolic bone markers, were tested for their association with change in knee cartilage volume over time.

Results: Mean (SD) reduction in tibial cartilage volume per year was 162 (93) μl. This represented a 2.8% reduction in total tibial articular cartilage per year (95% confidence interval, 0.2% to 5.5%). Tibial cartilage loss was associated with serum free testosterone level, independently of age, body mass index, baseline tibial cartilage volume tibial plateau area, and total bone mineral content. Overall, testosterone accounted for 14.5% (partial r2) of the variation in change in tibial cartilage volume. There was a trend towards a positive association between tibial cartilage loss and urinary N-telopeptide cross-links of type I collagen (Ntx) (p = 0.057).

Conclusions: Further studies will be required to determine whether hormonal manipulation or treatment with antiresorptive drugs will reduce the risk of knee osteoarthritis in men in later life.

  • DHEAS, dehydroepianosterone sulphate
  • DPD, deoxypyridinoline corrected for creatinine
  • DXA, dual energy x ray absorptiometry
  • LH, luteinising hormone
  • NTx, N-telopeptide cross links of type I collagen
  • PYD, pyridinoline corrected for creatinine
  • SHBG, sex hormone binding globulin
  • TBBMC, total body bone mineral content
  • knee
  • cartilage
  • risk factors

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