Femoropatellar Joint Reaction Detected During a 4486 KM Ultramarathon with Mobile MRI

Abstract

Almost nothing is known about the condition of the knee joints of multistage ultra-marathon (MSUM) runner. This is first image-based investigation of the femoropatellar joint (FPJ) using a mobile 1.5T MRI accompanying the MSUM TransEurope Foot-Race (TEFR) 64 stages over 4486 km. Twenty-two (20 male) subjects got a knee MRI-protocol at defined measurement intervals during TEFR: T2*-mapping (FLASH T2*-GRE), TIRM, and fat saturated PD -sequence. In the FPJ 12 different regions were evaluated regarding cartilage T2* and thickness changes and cartilage lesions in course of TEFR and a test on possible compounding factors (running burden, BMI, age) was done if being appropriate. No significant changes in cartilage thickness- and T2*-values were found during TEFR. In 8 runners, at least one single cartilage lesion (Grade 2–3) was found at baseline, but no significant race-related adjacent T2*-changes or progress of the defects could be detected. Analyses on compounding factors were negative. In knees with MPP (5) significantly lower adjacent T2*-values were found. The extreme running burden of a MSUM seems not to have a relevant negative influence on the FPJ tissues, even if cartilage lesions are present.

A mobile MRI field study of the biochemical cartilage reaction of the knee joint during a 4,486 km transcontinental multistage ultra-marathon using T2* mapping

“…As animal experiments have shown that ongoing ultra-long load bearing exercises minimize the development of OA in rats 96 and dogs 83 , and as our collective of highly adapted and experienced ultra-runners 105 did not show increased cartilage degeneration, we found significant recovery of T2 values after TEFR (tx), as reported in all three published post-marathon studies with a second follow-up 34,39,40 www.nature.com/scientificreports www.nature.com/scientificreports/ burden does not correspond to increased OA or overuse lesions in the human knee joint when relevant cartilage injuries or malalignments are absent 16,106 . Therefore, despite the problems that have been discussed with overuse injuries in ultra-marathon running [107][108][109][110][111][112][113][114] , MSUMs do not seem to have a negative effect, but rather a favourable influence, on cartilage.…”

“…The results of this mobile MRI-based field study allow us to refute a relevant negative influence of ultra-long running distances on knee joint cartilage in ultra-marathoners 106 . However, in addition to the factor of running distance, there are other external running-specific characteristics (e.g., competition runners, mountain running with inclines and descents, cross-country running with enhanced multiaxial stress on the knee joints., interval running with partially high running speed, etc.)…”

Right Knee—The Weakest Point of the Best Ultramarathon Runners of the World? A Case Study

“…Some MRI studies show that even running 4487 km in a multistage UM does not cause permanent negative changes in the knee joint [13,14]. Potential overload injuries during long runs are influenced by a number of individual factors: biochemical, clinical, and anthropometric [15].…”

Study of the Kinetics of the Determinants of Performance During a Mountain Ultramarathon: Multidisciplinary Protocol of the First Trail Scientifique de Clécy 2021

“…Unfortunately, these studies often focus on one variable or field of study [ 5 - 26 ], particularly cardiac, renal, or psychomotivational functions. Moreover, of these 23 studies, 12 (52%) protocols were conducted on a treadmill [ 5 , 13 , 19 , 27 ], on roads or nontechnical trails [ 6 , 10 , 12 , 18 , 23 , 28 ], on short distances [ 16 ], or in an extreme environment [ 7 ].…”