Nocturnal changes in knee cartilage thickness in young healthy adults

Magnetic resonance imaging (MRI) allows one to analyze cartilage physiology in vivo. Cartilage deforms during loading, but little is known about its recovery after deformation. Here we study 'nocturnal' changes in knee cartilage thickness and whether postexercise deformation differs between morning and evening. Axial magnetic resonance (MR) images were acquired in the right knees of 17 healthy volunteers (age 23.5 ± 3.0 years) after a normal day, and then after 30 deep knee bends. Coronal images were additionally acquired in 8 of these volunteers after a normal day and then after 2 min of static loading of the leg with 150% body weight. The volunteers then remained unloaded overnight and the same protocol was repeated in the morning. A significant increase (p < 0.01) in cartilage thickness was observed between evening (preexercise) and morning (preexercise): +2.4% in the patella, +8.4% in the medial tibia and +6.2% in the lateral tibia. Deformation in the morning (-6.8/ -4.6/-5.1%) was generally greater than that in the evening (-5.4/-3.2/-3.7%), but this difference did not reach statistical significance. No significant difference in the nocturnal thickness increase (or postexercise deformation) was observed between men and women. We conclude that knee cartilage (thickness) recovers overnight by approximately 2-8%, independent of sex. Given the lack of 'predeformation' after nocturnal periods of unloading, morning postexercise deformation of the cartilage may have a greater magnitude than evening postexercise deformation.