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Ann Rheum Dis. Apr 2004; 63(4): 444–449.
PMCID: PMC1754949

Tibial cartilage volume change in healthy postmenopausal women: a longitudinal study


Objective: To determine whether the amount of joint cartilage in healthy postmenopausal women is stable or changes over time, and whether oestrogen replacement therapy (ERT) influences this.

Design: A cohort study in healthy postmenopausal women without knee pain, initially selected on the basis of having either used ERT long term (more than five years) or never having used ERT.

Methods: 81 women (42 taking ERT and 39 non-users) had baseline knee radiographs and magnetic resonance imaging (MRI) on the dominant knee; 57 of these (70%) were followed with repeat MRI approximately 2.5 years later. Knee cartilage volume was measured at baseline and at follow up. Risk factors assessed at baseline, including ERT use, were tested for their association with change in knee cartilage volume over time.

Results: 29 subjects who were initially taking ERT and 28 non-users at baseline completed the study. Total tibial articular cartilage decreased, on average, by (mean (SD)) 2.4 (3.2)% per year (95% confidence interval for mean, 1.5% to 3.2%). Average annual reduction in medial and lateral tibial cartilage was 2.4 (3.6)% (1.4% to 3.3%) and 2.3 (4.2)% (1.2% to 3.4%), respectively. No association between ERT and the rate of reduction in cartilage volume was shown.

Conclusions: Mean tibial cartilage volume loss in healthy postmenopausal women is between 1.5% and 3.2% a year. Whether this rate of change is similar throughout adult life or in men will require further investigation.

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Selected References

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  • Slemenda C, Heilman DK, Brandt KD, Katz BP, Mazzuca SA, Braunstein EM, Byrd D. Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women? Arthritis Rheum. 1998 Nov;41(11):1951–1959. [PubMed]
  • Cooper C, Snow S, McAlindon TE, Kellingray S, Stuart B, Coggon D, Dieppe PA. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000 May;43(5):995–1000. [PubMed]
  • Nevitt MC, Felson DT. Sex hormones and the risk of osteoarthritis in women: epidemiological evidence. Ann Rheum Dis. 1996 Sep;55(9):673–676. [PMC free article] [PubMed]
  • Bayliss MT, Ali SY. Age-related changes in the composition and structure of human articular-cartilage proteoglycans. Biochem J. 1978 Dec 15;176(3):683–693. [PMC free article] [PubMed]
  • Glant TT, Mikecz K, Roughley PJ, Buzás E, Poole AR. Age-related changes in protein-related epitopes of human articular-cartilage proteoglycans. Biochem J. 1986 May 15;236(1):71–75. [PMC free article] [PubMed]
  • Roughley PJ, Mort JS. Ageing and the aggregating proteoglycans of human articular cartilage. Clin Sci (Lond) 1986 Oct;71(4):337–344. [PubMed]
  • Stanescu V, Chaminade F, Muriel MP. Age-related changes in small proteoglycans of low buoyant density of human articular cartilage. Connect Tissue Res. 1988;17(4):239–252. [PubMed]
  • Verzijl Nicole, DeGroot Jeroen, Ben Zaken Chaya, Brau-Benjamin Orit, Maroudas Alice, Bank Ruud A, Mizrahi Joe, Schalkwijk Casper G, Thorpe Suzanne R, Baynes John W, et al. Crosslinking by advanced glycation end products increases the stiffness of the collagen network in human articular cartilage: a possible mechanism through which age is a risk factor for osteoarthritis. Arthritis Rheum. 2002 Jan;46(1):114–123. [PubMed]
  • Hudelmaier M, Glaser C, Hohe J, Englmeier KH, Reiser M, Putz R, Eckstein F. Age-related changes in the morphology and deformational behavior of knee joint cartilage. Arthritis Rheum. 2001 Nov;44(11):2556–2561. [PubMed]
  • Jones G, Glisson M, Hynes K, Cicuttini F. Sex and site differences in cartilage development: a possible explanation for variations in knee osteoarthritis in later life. Arthritis Rheum. 2000 Nov;43(11):2543–2549. [PubMed]
  • Wluka Anita E, Stuckey Stephen, Snaddon Judith, Cicuttini Flavia M. The determinants of change in tibial cartilage volume in osteoarthritic knees. Arthritis Rheum. 2002 Aug;46(8):2065–2072. [PubMed]
  • Wluka AE, Davis SR, Bailey M, Stuckey SL, Cicuttini FM. Users of oestrogen replacement therapy have more knee cartilage than non-users. Ann Rheum Dis. 2001 Apr;60(4):332–336. [PMC free article] [PubMed]
  • Spector TD, Harris PA, Hart DJ, Cicuttini FM, Nandra D, Etherington J, Wolman RL, Doyle DV. Risk of osteoarthritis associated with long-term weight-bearing sports: a radiologic survey of the hips and knees in female ex-athletes and population controls. Arthritis Rheum. 1996 Jun;39(6):988–995. [PubMed]
  • Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988 Dec;15(12):1833–1840. [PubMed]
  • Altman RD, Hochberg M, Murphy WA, Jr, Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage. 1995 Sep;3 (Suppl A):3–70. [PubMed]
  • Cicuttini F, Forbes A, Morris K, Darling S, Bailey M, Stuckey S. Gender differences in knee cartilage volume as measured by magnetic resonance imaging. Osteoarthritis Cartilage. 1999 May;7(3):265–271. [PubMed]
  • Chuang-Stein C, Tong DM. The impact and implication of regression to the mean on the design and analysis of medical investigations. Stat Methods Med Res. 1997 Jun;6(2):115–128. [PubMed]
  • Sowers M, Lachance L, Jamadar D, Hochberg MC, Hollis B, Crutchfield M, Jannausch ML. The associations of bone mineral density and bone turnover markers with osteoarthritis of the hand and knee in pre- and perimenopausal women. Arthritis Rheum. 1999 Mar;42(3):483–489. [PubMed]
  • Cicuttini Flavia M, Forbes Andrew, Yuanyuan Wang, Rush Glen, Stuckey Stephen L. Rate of knee cartilage loss after partial meniscectomy. J Rheumatol. 2002 Sep;29(9):1954–1956. [PubMed]
  • Cummings SR, Black D. Should perimenopausal women be screened for osteoporosis? Ann Intern Med. 1986 Jun;104(6):817–823. [PubMed]
  • Wluka AE, Cicuttini FM, Spector TD. Menopause, oestrogens and arthritis. Maturitas. 2000 Jun 30;35(3):183–199. [PubMed]
  • Cicuttini FM, Wluka AE, Stuckey SL. Tibial and femoral cartilage changes in knee osteoarthritis. Ann Rheum Dis. 2001 Oct;60(10):977–980. [PMC free article] [PubMed]
  • Melton LJ, 3rd, Atkinson EJ, O'Connor MK, O'Fallon WM, Riggs BL. Determinants of bone loss from the femoral neck in women of different ages. J Bone Miner Res. 2000 Jan;15(1):24–31. [PubMed]

Figures and Tables

Figure 1
Individual annual percentage rate of tibial cartilage loss for healthy postmenopausal women. The y axis represents the number of subjects with a given percentage of tibial cartilage loss. The mean (SD) annual rate of cartilage loss was 2.4 (3.2)% (n ...

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