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Menopause is associated with articular cartilage degeneration: a clinical study of knee joint in 860 women

Lou, Chao MD; Xiang, Guangheng MD; Weng, Qiaoyou MD; Chen, Zhaojie MD; Chen, Deheng MD; Wang, Qingqing MD; Zhang, Di MD; Zhou, Bin MD; He, Dengwei MD; Chen, Hongliang MD, PhD

doi: 10.1097/GME.0000000000000697
Original Articles

Objective: The purpose of this study was to investigate the association between menopause and severity of knee joint cartilage degeneration using a magnetic resonance imaging-based six-level grading system, with six cartilage surfaces, the medial and lateral femoral condyle, the femoral trochlea, the medial and lateral tibia plateau, and the patella.

Methods: The study cohort comprised 860 healthy women (age 36-83 y), and 5,160 cartilage surfaces were analyzed. Age, weight, height, age at natural menopause, and years since menopause (YSM) were obtained. Cartilage degeneration was assessed using a magnetic resonance imaging-based six-level grading system.

Results: After removing the age, height, and weight effects, postmenopausal women had more severe cartilage degeneration than pre- and perimenopausal women (P < 0.001). A positive trend was observed between YSM and severity of cartilage degeneration (P < 0.05). Postmenopausal women were divided into seven subgroups by every five YSM. When YSM was less than 25 years, the analysis of covariance indicated a significant difference in medial tibia plateau, medial femoral condyle, trochlea, patella, and total surfaces (P < 0.05 or 0.01) between every two groups. When YSM was more than 25 years, the significant difference, however, disappeared in these four surfaces (P > 0.05). No significant difference was observed in lateral tibia plateau and lateral femoral condyle in postmenopausal women.

Conclusions: Menopause is associated with cartilage degeneration of knee joint. After menopause, cartilage showed progressive severe degeneration that occurred in the first 25 YSM, suggesting estrogen deficiency might be a risk factor of cartilage degeneration of the knee joint. Further studies are needed to investigate whether age or menopause plays a more important role in the progression of cartilage degeneration in the knee joint.

1Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang, People's Republic of China

2Department of Orthopedic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China

3Department of Interventional Radiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang, People's Republic of China.

Address correspondence to: Hongliang Chen, MD, PhD, Department of Orthopedic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, Zhejiang 325027, People's Republic of China, E-mail: chl791124@163.com and Dengwei He, MD, Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, 289 Kuocang Road, Lishui, Zhejiang 323000, People's Republic of China, E-mail: hedw120@163.com

Address reprint requests to: Chao Lou, MD, Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, 289 Kuocang Road, Lishui, Zhejiang 323000, People's Republic of China. E-mail: 564776324@qq.com

Received 3 November, 2015

Revised 14 April, 2016

Accepted 14 April, 2016

D.H. and H.C. contributed equally to this work.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

© 2016 by The North American Menopause Society.