Short-Term Impact of Volleyball Workout on Knee Cartilage Thickness

Hsin-Min Wang*, PhD, Jen-Chieh Lai†, MD, Yin-Chou Lin‡, PhD,

Chin-Chih Chiou*, MS, Yi-Wen Chen*, PhD

*National Changhua University of Education†Taichung Armed Forces General Hospital

‡Chang Gung Memorial Hospital

Introduction

• Knee cartilage health is critical to being able to perform activities of daily living

• A main function of articular cartilage is the absorption and redistribution of forces applied to the joint during daily or intensive activities (Ateshian et al 1994)

• Proper mechanical loading is critical to maintain the function of knee cartilage (Jorgensen et al 2017)

Introduction

• Repetitive loading may modify knee articular cartilage macrostructure and potential impact knee cartilage health

• Walking and running created greater medial knee cartilage deformation than control conditions (Harkey et al 2017)

• Suggests that sports activity may impact the cartilage health

• Acute structural responses to explosive sporting activity are not well understood

Purpose

• To determine changes in knee femoral condyle cartilage thickness in response to 30 minutes of volleyball-specific activity

Participants

• 22 healthy division Ι collegiate volleyball athletes

• (19.6 ± 1.1yrs, 77.0 ± 10.8kg, 182.5 ± 5.3cm, 23.1 ± 2.9 kg/m2 )

• With no current orthopedic injury or history of knee surgery in both knees

• Body mass index (BMI) of < 30 kg/m2

Methods

• Longitudinally obtained medial femoral condylar cartilage thickness on both limbs before, immediately after, and one hour after a 30 minutes volleyball workout

• Intratester ICC2,3 = 0.8, SEM = 0.01 mm

Methods

RestPre

US

Volleyballworkout

Post

US

Post

US

30

Minutes

30

Minutes

One hour after workout

• 7 minutes of dynamic warm-up exercise

• 25 receiving, 25 blocking, and 12 spiking

Methods-Cartilage Measures (Middle)

Pre medial femoral cartilage thickness from USD image

Post medial femoral cartilage thickness from USD image

Statistical Analysis

• Two-way repeated measures ANOVA examined the differences in right and left knees femoral condyle cartilage thickness before, immediately, and an hour later of 30 minutes volleyball workout

Results

Left Limb (mm) Right Limb(mm)

Medial Femoral Cartilage Regions

Pre USD measure 1.7 ± 0.2 1.6 ± 0.2

Immediate USD measure 1.8 ± 0.3* 1.8 ± 0.3*

One hour USD measure 1.6 ± 0.2 1.6 ± 0.2

• Statistically different (P <.05) between pre-workout to immediately post-workout and between immediately post-workout to an hour later of post-workout

Results

• Significant main effect of time points on knee cartilage thickness, F (2,42) = 40.599, p <.001

• Knee cartilage thickness increased from pre-workout to immediately post workout (1.6 ±0.2 mm Vs 1.8 ± 0.3 mm, p ≤.001)

• Knee cartilage thickness decreased from immediately post workout to an hour post-workout (1.8 ± 0.3 mm Vs 1.7 ± 0.2 mm, p ≤.001)

Results

• No significant main effect of limb on knee cartilage thickness, F (1,21) = 3.127, p =.092

• The left knee cartilage thickness was similar with right limb

• No interaction between limb and time points on knee cartilage measures, F (2,42) = 1.684, p =.198

Conclusion

• After 30 minutes volleyball workout, middle region of knee cartilage thickness was thicker than pre-workout and was recovered an hour later after workout

• This work suggests that volleyball workout induced short-term morphologic changes in knee cartilage

• Ultrasound is a reliable modality to monitor medial cartilage deformation

Future Goal

• To investigate how long-term volleyball workout could impact cartilage health

• To investigate how other high impact activities may impact the cartilage health

Conflict of Interest

• This work is funded by the Ministry Science and Technology (MOST) (MOST 109-2410-H-018-023)

Acknowledgments

• All my co-authors

• NCUE faculty

• UNCG faculty