Moderate physical activity may prevent cartilage loss in women with knee osteoarthritis: data from the Osteoarthritis Initiative

Alessio Bricca* (Corresponding Author), Wolfgang Wirth, Carsten B. Juhl, Jana Kemnitz, David J. Hunter, C. Kent Kwoh, Felix Eckstein, Adam G. Culvenor

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)
18 Downloads (Pure)


To examine the impact of physical activity (PA) on cartilage thickness loss in knee osteoarthritis (KOA).

689 participants with radiographic KOA (Kellgren/Lawrence grade ≥2) at baseline, from the Osteoarthritis Initiative completed the Physical Activity Scale for the Elderly (PASE) questionnaires at annual intervals over four years. Magnetic resonance imaging‐based cartilage thickness change in the medial femorotibial compartment (MFTC) over four years was the main outcome. The impact of PASE tertiles (low, moderate, high) on changes in MFTC cartilage thickness was estimated using a mixed effect model adjusted for baseline characteristics. Furthermore, straficiation by sex was performed for secondary analyses.

Structural progression of MFTC cartilage loss of ‐0.20 mm (95% confidence interval: ‐0.22 to ‐0.17mm) was observed in the entire cohort, with no statistically significant difference between PA levels after adjustment for baseline characteristics. A sex‐by‐physical activity interaction was observed in the adjusted analysis (p=0.02). Stratification by sex showed that women with low PA had a statistically greater cartilage loss than women with moderate PA level (adjusted between group difference ‐0.09 mm [‐0.16 to ‐0.02 mm]), whereas no significant differences were observed in men.

While physical activity was not associated with cartilage thickness loss in the whole cohort, this relationship significantly differed between sexes. In women, but not in men, moderate PA may slow down structural disease progression compared to low PA levels. For both men and women, high PA does not appear to be more detrimental than lower PA levels for cartilage thickness loss.
Original languageEnglish
Pages (from-to)218-226
Number of pages9
JournalArthritis Care & Research
Issue number2
Early online date19 Oct 2018
Publication statusPublished - 1 Feb 2019

Bibliographical note

All authors have completed the ICMJE uniform disclosure form at and declare: data acquisition in this study was funded by the Osteoarthritis Initiative, a public–private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259;N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the Osteoarthritis Initiative study Investigators. Private funding partners of the OAI include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer, Inc. Private sector funding for the Osteoarthritis Initiative is managed by the Foundation for the National Institutes of Health. The image analysis in this study was partly funded by the FNIH OA Biomarkers Consortium, with grants, direct and in -kind contributions, provided by: AbbVie; Amgen Inc.; Arthritis Foundation; Bioiberica S.A.; DePuy Mitek, Inc.; Flexion Therapeutics, Inc.; GlaxoSmithKline; Merck KGaA; Rottapharm | Madaus; Sanofi; and Stryker. Other parts of funding were provided by a direct grant from Merck KGaA, by a contract with the University of Pittsburgh (Pivotal OAI MRI Analyses [POMA]: NIH/NHLBI Contract No. HHSN2682010000 21C), by a vendor contract from the OAI coordinating center at University of California, San Francisco (N01-AR-2-2258), and by an ancillary study to the OAI held by the Division of Rheumatology, Feinberg School of Medicine, Northwestern University (R01 AR52918). This research has also received funding from the European Union Seventh Framework Programme (FP7-PEOPLE-2013-ITN; KNEEMO) under grant agreement number 607510. AGC is supported by a National Health and Medical Research Council (NHMRC) of Australia Early Career Fellowship (Neil Hamilton Fairley Clinical Fellowship No.1121173). The sponsors were not involved in the design and conduct of this particular study, in the analysis and interpretation of the data, and in the preparation, review, or approval of the manuscript.


  • physical activity
  • cartilage
  • load
  • thickness
  • osteoarthritis
  • RISK


Dive into the research topics of 'Moderate physical activity may prevent cartilage loss in women with knee osteoarthritis: data from the Osteoarthritis Initiative'. Together they form a unique fingerprint.

Cite this