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



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.



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.



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.
Chao
C
Lou
Guangheng
G
Xiang
Qiaoyou
Q
Weng
Zhaojie
Z
Chen
Deheng
D
Chen
Qingqing
Q
Wang
Di
D
Zhang
Bin
B
Zhou
Dengwei
D
He
Hongliang
H
Chen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002357:Cartilage Diseases / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000473:pathology*; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology