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Magnetic resonance imaging of lower limb joints of marathon runners

Horga, Laura-Maria; (2021) Magnetic resonance imaging of lower limb joints of marathon runners. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Marathon running is extremely popular. The increasing participation of beginner runners, including older ones, in marathon races has been anecdotally associated with an increase in lower limb injuries. Evidence is scarce, yet no previous study showed significant marathon-related damage on joints, but involved small sample size, no beginner runners and injury detection tools of limited sensitivity. Therefore, the impact of marathon running remains unclear. The aim of this thesis is to better understand how marathon running affects the knee and hip joints of large groups of novice marathoners, and how to minimise risks of injury. Prevalence of knee joint abnormalities in asymptomatic novice marathoners before the start of their marathon training was morphologically assessed, using high-resolution 3.0 T MRI and validated questionnaires; 97% knees had abnormalities and the patellofemoral compartment was most lesioned (p<0.0001). Changes in the knee MRI results from the pre-marathon scan to short-term post-marathon scan were evaluated, using 3.0 T MRI and questionnaires. For the first time, counterbalanced effects of running were detected: reduction in the extent of pre-existing tibiofemoral bone marrow edema (p=0.082), and increase in the prevalence of patellofemoral cartilage lesion (p=0.0005), although asymptomatic. Six months later, the reduction in bone edema was sustained in all cases and there were signs of reversibility of cartilage damage (14%). Prevalence of hip joint abnormalities in both asymptomatic novice marathoners and experienced marathoners was evaluated, using the same methodology. Prevalences were relatively moderate in both experienced marathoners (63%) and non-experienced marathoners (51%). Changes in the hip MRI findings of novice marathoners after marathon running were analysed, and no significant changes were detected (p=0.684). Results from this thesis show that first-time marathon running does not damage the knee and hip joints of runners with no pre-existing injuries, and inform on the types of structural changes and potential clinical implications.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Magnetic resonance imaging of lower limb joints of marathon runners
Event: UCL
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/10123190
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