Knee Cartilage Composition, Morphology, and Function in Asymptomatic Recreational Runners, Non-Runners, and Obese Adults: A Matched 4HAIE MRI Study.

Authors

Lukáš Slovák, Jan Plešek, Lucie Šustková, David Zahradník, Jaroslav Uchytil, Jan Šustek, Jiri Skypala, Jan Urbaczka, Miloš Golián, Miika T Nieminen, Victor Casula, Daniel Jandačka

Published in

Medicine and science in sports and exercise. Aug 27, 2026. Epub Aug 27, 2026.

Abstract

Identifying early alterations in asymptomatic individuals with different physical activity levels and/or BMI is essential for understanding joint health before clinical symptoms develop.
The aim of this study was to compare cartilage composition, morphology, and subjective knee function among age- and sex-matched recreational runners (R), non-runners (NR), and obese individuals with BMI ≥ 30 kg/m²) (O).
This cross-sectional study included 183 asymptomatic adults (61 age- and sex-matched triplets: R, NR, O), aged 18-65 years, from the 4HAIE cohort, with an average age difference of 214 ± 87 days within triplets. MRI (1.5 Tesla) was used to quantify T2 relaxation times and assess morphology (Normal vs. Abnormal/Degenerated) across 12 femorotibial regions. Knee function was evaluated with the KOOS questionnaire. Group differences were tested using non-parametric statistics. Cartilage morphology was further examined by binary logistic regression.
Runners showed significantly higher T2 values in several lateral femoral and tibial regions compared with NR and O (p < 0.05). Obese had a lower prevalence of normal cartilage in the medial central tibia (O: 75.4% vs. R: 91.8% vs. NR: 93.4%) and up to fourfold higher odds of abnormal findings (R/O: OR = 3.65, 95% CI: 1.30-10.23; NR/O: OR = 4.65, 95% CI: 1.44-14.92). KOOS scores were lowest in obese, particularly for Activities of Daily Living (p = 0.004). No significant differences in morphology or function were observed between runners and non-runners.
Obesity (BMI ≥ 30 kg/m²) was associated with a higher prevalence of cartilage abnormalities and poorer self-reported function in activities of daily living, whereas recreational running was not linked to structural or functional impairment.

PMID:
42647447
Bibliographic data and abstract were imported from PubMed on 27 Aug 2026.

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