Vastus medialis fat infiltration – A modifiable determinant of knee cartilage loss

Abstract

Purpose: Although obesity is a risk factor for hip osteoarthritis (OA), the role of body composition, if any, is unclear. This study examines whether obesity and body composition are associated with hip cartilage changes using magnetic resonance imaging (MRI) in community-based adults. Methods: 141 community-based participants with no clinical hip disease, including OA, had BMI and body composition (fat mass and fat free mass) measured at baseline (1990 to 1994), and BMI measured and 3.0T MRI performed at follow-up (2009-2010). Femoral head cartilage volume was measured and femoral head cartilage defects were scored in the different hip regions. Results: For females, baseline BMI (b¼-26mm 3 , 95% CI-47 to-6mm 3 , p¼0.01) and fat mass (b¼-11mm 3 , 95% CI-21 to-1mm 3 , p¼0.03) were negatively associated with femoral head cartilage volume. Also, while increased baseline fat mass was associated with an increased risk of cartilage defects in the central superolateral region of the femoral head (OR¼ 1.08, 95% CI 1.00-1.15, p¼0.04), increased baseline fat free mass was associated with a reduced risk of cartilage defects in this region (OR¼0.82, 95% CI 0.67-0.99; p¼0.04). For males, baseline fat free mass was associated with increased femoral head cartilage volume (b¼ 40mm 3 , 95% CI 6 to 74mm 3 , p¼0.02) Conclusions: Increased fat mass was associated with adverse hip cartilage changes for females, while increased fat free mass was associated with beneficial cartilage changes for both genders. Further work is required to determine whether modifying obesity and in particular body composition alters the development of hip OA.

Systemic and local adipose tissue in knee osteoarthritis

“…Higher quadriceps intra-muscular adipose tissue was associated with advanced age, worse K-L score, and greater cartilage and meniscus lesions, and also predicted selfreported disability 12 . Teichtahl et al investigated the association between intra-muscular adipose tissue infiltration in vastus medialis (VM), a functionally important quadriceps muscle, and knee cartilage volume, and reported that reduced VM adipose tissue infiltration could predict the reduction of annual loss of cartilage volume in both medial tibial and patellar sites 27 . They also examined the determinants of VM adipose tissue infiltration and reported that age, female gender, BMI and weight had positive, while physical activity had negative, associations with baseline VM adipose tissue infiltration.…”

Association of Quadriceps Adiposity With an Increase in Knee Cartilage, Meniscus, or Bone Marrow Lesions Over Three Years

“…Intramuscular quadriceps adiposity is increasingly being recognized as an important component of knee osteoarthritis (OA) pathogenesis (1)(2)(3). The mechanisms are likely related to release of inflammatory cytokines from the adipose tissue and their effects on the knee joint, as well as the effects of muscle adiposity on muscle function (4).…”

Muscle and Osteoarthritis Joint Status: Current Research Highlights and Their Implications

“…To verify or dispute hypothetical evidence based associations depicted in Figure 1 and expand upon trends depicted in Table 2, more prospective studies focusing on muscle co-activation effects [17], the role of eccentric as well as concentric forces on the emergence and progression of osteoarthritic joint disease [40], as well as the role of distant muscles [42,69], and the tendon-aponeurosis complex [46] are indicated [46,59]. In addition, delineating the role of muscle fat infiltration [33,81], muscle inflammation [25], and vitamin D [30] and its impact on muscle structure and function in the context of osteoarthritis may…”