ArticleScientific reports2020
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.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- TheFrontiers in physiology · 2026Pooled it
- Ultrashort echo time bi-component analysis of tibiotalar articular cartilage after long-distance running.European radiology · 2026Article
- From Tissue to System: What Constitutes an Appropriate Response to Loading?Sports medicine (Auckland, N.Z.) · 2025Review
- Effects of long-term running on the structure and biochemical composition of knee cartilage in males: a cross-sectional study.Quantitative imaging in medicine and surgery · 2024Article
- Imaging of joint response to exercise with MRI and PET.Skeletal radiology · 2023Review
- Authors' Reply to Dahmen et al.: "The Influence of Running on Lower Limb Cartilage: A Systematic Review and Meta-Analysis".Sports medicine (Auckland, N.Z.) · 2022Article
- Minimally Invasive Polarization Sensitive Optical Coherence Tomography (PS-OCT) for assessing Pre-OA, a pilot study on technical feasibility.Osteoarthritis and cartilage open · 2022Article
- Use of a Small Car-Mounted Magnetic Resonance Imaging System for On-Field Screening for Osteochondritis Dissecans of the Humeral Capitellum.Diagnostics (Basel, Switzerland) · 2022Article
- Study of the Kinetics of the Determinants of Performance During a Mountain Ultramarathon: Multidisciplinary Protocol of the First Trail Scientifique de Clécy 2021.JMIR research protocols · 2022Article
- Analysis of Knee Joint Injury Caused by Physical Training of Freshmen Students Based on 3T MRI and Automatic Cartilage Segmentation Technology: A Prospective Study.Frontiers in endocrinology · 2022Article
- Right Knee-The Weakest Point of the Best Ultramarathon Runners of the World? A Case Study.International journal of environmental research and public health · 2020Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Nearly nothing is known about the consequences of ultra-long-distance running on knee cartilage. In this mobile MRI field study, we analysed the biochemical effects of a 4,486 km transcontinental multistage ultra-marathon on femorotibial joint (FTJ) cartilage. Serial MRI data were acquired from 22 subjects (20 male, 18 finisher) using a 1.5 T MR scanner mounted on a 38-ton trailer, travelling with the participants of the TransEurope FootRace (TEFR) day by day over 64 stages. The statistical analyses focused on intrachondral T2* behaviour during the course of the TEFR as the main outcome variable of interest. T2* mapping (sagittal FLASH T2* weighted gradient echo) is a validated and highly accurate method for quantitative compositional cartilage analysis of specific weightbearing areas of the FTJ. T2* mapping is sensitive to changes in the equilibrium of free intrachondral water, which depends on the content and orientation of collagen and the proteoglycan content in the extracellular cartilage matrix. Within the first 1,100 km, a significant running load-induced T2* increase occurred in all joint regions: 44.0% femoral-lateral, 42.9% tibial-lateral, 34.9% femoral-medial, and 25.1% tibial-medial. Osteochondral lesions showed no relevant changes or new occurrence during the TEFR. The reasons for stopping the race were not associated with knee problems. As no further T2* elevation was found in the second half of the TEFR but a decreasing T2* trend (recovery) was observed after the 3,500 km run, we assume that no further softening of the cartilage occurs with ongoing running burden over ultra-long distances extending 4,500 km. Instead, we assume the ability of the FTJ cartilage matrix to reorganize and adapt to the load.
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