AccScience Publishing / OTE / Online First / DOI: 10.36922/OTE026100007
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ORIGINAL RESEARCH ARTICLE

Effect of unloading time, leg, and sex on distal femoral cartilage thickness

Michele LeBlanc1* Mari Carmen Bufkin1 Sophia Muller1
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1 Exercise Science Department, California Lutheran University, Thousand Oaks, California, United States of America
Received: 5 March 2026 | Revised: 9 April 2026 | Accepted: 11 May 2026 | Published online: 26 June 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Numerous studies that have investigated distal femoral cartilage thickness before and after a prescribed loading activity have included a rest period prior to the loading activity to remove the effects of previous activities that may have compressed the cartilage. The purpose of this study was to systematically determine how unloading time affects cartilage thickness, as well as how sex and leg preference influence the thickness in young, active adults with no knee injuries. Thirty-two healthy college students (16 female, 16 male) who regularly participated in moderate or vigorous physical activity were recruited and instructed to refrain from any physical activity at least 12 h prior to data collection. Ultrasound images were initially obtained for each leg and then every 15 min for an hour (T0, T15, T30, T45, T60) using a Mindray 7 machine. Between collections, they had their legs extended in front of them. Their leg preference was determined using the Waterloo Footedness Questionnaire. Cartilage thickness was measured at the intercondylar notch (IC), medial condyle (MC), and lateral condyle (LC). The results suggest that the cartilage at the LC experiences less compression than the other regions. Among individuals who have reduced their physical activity for at least 12 h, resting with legs extended for 30 min appears to allow the IC and MC cartilage to recover and create equivalent conditions for all participants. While female values were lower than those of males across all regions, there was no difference in their response to unloading.

Keywords
Ultrasound
Leg preference
Medial condyle
Lateral condyle
Funding
This project was partially funded by the Swenson Summer Research Fellowship Program.
Conflict of interest
The authors declare they have no competing interests.
References
  1. Sophia Fox AJ, Bedi A, Rodeo SA. The basic science of articular cartilage: Structure, composition, and function. Sports Health. 2009;1(6):461-468. doi: 10.1177/1941738109350438
  2. Liu Y, Shah KM, Luo J. Strategies for articular cartilage repair and regeneration. Front Bioeng Biotechnol. 2021;9. doi: 10.3389/fbioe.2021.770655
  3. Taylor SJ, Walker PS, Perry JS, Cannon SR, Woledge R. The forces in the distal femur and the knee during walking and other activities measured by telemetry. J Arthroplast. 1998;13(4):428-437. doi: 10.1016/s0883-5403(98)90009-2
  4. Taylor WR, Heller MO, Bergmann G, Duda GN. Tibio-femoral loading during human gait and stair climbing. J Orthop Res. 2004;22(3):625-632. doi: 10.1016/j.orthres.2003.09.003
  5. Pane RV, Setiyaningsih R, Widodo G, Al Hajiri AZZ, Salsabil JR. Femoral cartilage thickness in knee osteoarthritis patients and healthy adults: An ultrasound measurement comparison. Sci World J. 2023;2023:e3942802. doi: 10.1155/2023/3942802
  6. Naredo E, Acebes C, Möller I, et al. Ultrasound validity in the measurement of knee cartilage thickness. Ann Rheum Dis. 2009;68(8):1322-1327. doi: 10.1136/ard.2008.090738
  7. Roberts HM, Moore JP, Jones JG, Griffith-McGeever C, Thom JM. The effect of vigorous running and cycling on novel markers of knee joint function. Med Sci Sports Exerc. 2015;47(5S):8. doi: 10.1249/01.mss.0000476411.69120.32
  8. Schmitz RJ, Wang HM, Polprasert DR, Kraft RA, Pietrosimone BG. Evaluation of knee cartilage thickness: A comparison between ultrasound and magnetic resonance imaging methods. Knee. 2017;24(2):217-223. doi: 10.1016/j.knee.2016.10.004
  9. Harkey MS, Blackburn JT, Davis H, Sierra-Arévalo L, Nissman D, Pietrosimone B. Ultrasonographic assessment of medial femoral cartilage deformation acutely following walking and running. Osteoarthr Cartil. 2017;25(6):907-913. doi: 10.1016/j.joca.2016.12.026
  10. Harkey MS, J. Troy Blackburn, Hackney AC, et al. Comprehensively assessing the acute femoral cartilage response and recovery after walking and drop-landing: An Ultrasonographic Study. Ultrasound Med Biol. 2018;44(2):311-320. doi: 10.1016/j.ultrasmedbio.2017.10.009
  11. Im SC, Kim K. Comparison of medial femoral cartilage deformation in normal adults according to gait conditions. J Exerc Rehabil. 2019;15(3):407-413. doi: 10.12965/jer.1938192.096
  12. Niehoff A, Müller M, Brüggemann L, et al. Deformational behaviour of knee cartilage and changes in serum cartilage oligomeric matrix protein (COMP) after running and drop landing. Osteoarthr Cartil. 2011;19(8):1003-1010. doi: 10.1016/j.joca.2011.04.012
  13. Azami P, Ashraf A, Yousefi O, et al. Impact of treadmill running on distal femoral cartilage thickness: a cross-sectional study of professional athletes and healthy controls. BMC Sports Sci Med Rehabil. 2024;16(1). doi: 10.1186/s13102-024-00896-4
  14. Lee J, Lim J, Park S, Kim S, Park J. Morphologic response in femoral cartilage during and after 40-Minute treadmill running. J Athl Train. 2024;59(9):906-914. doi: 10.4085/1062-6050-0659.22
  15. Park S, Lim J, Lee J, Jeon S, Kim J, Park J. Acute responses and recovery in the femoral cartilage morphology following running and cool-down protocols. PeerJ. 2024;12:e18302. doi: 10.7717/peerj.18302
  16. Bini RR, Bini AF. Effects of exercise mode in knee cartilage thickness. J Bodyw Mov Ther. 2020;24(4):490-495. doi: 10.1016/j.jbmt.2020.05.006
  17. Kilic G, Kilic E, Akgul O, Ozgocmen S. Ultrasonographic assessment of diurnal variation in the femoral condylar cartilage thickness in healthy young adults. Am J Phys Med Rehabil. 2015;94(4):297-303. doi: 10.1097/phm.0000000000000179
  18. Pfeiffer SJ, Davis‐Wilson HC, Pexa B, et al. Assessing step count–dependent changes in femoral articular cartilage using ultrasound. J Ultrasound Med. 2019;39(5):957-965. doi: 10.1002/jum.15180
  19. Harkey MS, Blackburn JT, Hackney AC, Lewek MD, Schmitz RJ, Pietrosimone B. Sex-specific associations between cartilage structure and metabolism at rest and acutely following walking and drop-landing. Cartilage. 2021;13(1_suppl):1772S-1781S. doi: 10.1177/1947603520959386
  20. Bedewi MA, Elsifey AA, Naguib MF, et al. Sonographic assessment of femoral cartilage thickness in healthy adults. J Int Med Res. 2020;48(8):030006052094875. doi: 10.1177/0300060520948754
  21. Otterness IG, Eckstein F. Women have thinner cartilage and smaller joint surfaces than men after adjustment for body height and weight. Osteoarthr Cartil. 2007;15(6):666-672. doi: 10.1016/j.joca.2006.12.003
  22. Özçakar L, Tunç H, Öken Ö, et al. Femoral cartilage thickness measurements in healthy individuals: Learning, practicing, and publishing with TURK-MUSCULUS. J Back Musculoskelet Rehabil. 2014;27(2):117-124. doi: 10.3233/bmr-130441
  23. Roberts HM, Moore JP, Thom JM. The reliability of suprapatellar transverse sonographic assessment of femoral trochlear cartilage thickness in healthy adults. J Ultrasound Med. 2018;38(4):935-946. doi: 10.1002/jum.14775
  24. Herrera H GA, Llinás PJ, Flórez L, et al. Ultrasound measurement of femoral cartilage thickness in the knee of healthy young university students. Rev Esp Cir Ortop Traumatol. 2020;64(4):244-250. doi: 10.1016/j.recot.2020.04.001
  25. Ariyachaikul S, Sriburee S, Thonglorm N, Kanthain R, Jankaew A. Comparison of knee articular cartilage thickness across sex and age groups in healthy adults. J Exp Orthop. 2025;12(4). doi: 10.1002/jeo2.70490
  26. Pamukoff DN, Montgomery MM, Holmes SC, Moffit TJ, Garcia SA, Vakula MN. Association between gait mechanics and ultrasonographic measures of femoral cartilage thickness in individuals with ACL reconstruction. Gait Posture 2018;65:221-227. doi: 10.1016/j.gaitpost.2018.07.174
  27. Elias LJ, Bryden MP, Bulman-Fleming MB. Footedness is a better predictor than is handedness of emotional lateralization. Neuropsychologia. 1998;36(1):37-43. doi: 10.1016/s0028-3932(97)00107-3
  28. Bruns J, Volkmer M, Luessenhop S. Pressure distribution in the knee joint. Arch Orthop Trauma Surg. 1994;113(4):204-209. doi: 10.1007/bf00441833
  29. Winby CR, Lloyd DG, Besier TF, Kirk TB. Muscle and external load contribution to knee joint contact loads during normal gait. J Biomech. 2009;42(14):2294-2300. doi: 10.1016/j.jbiomech.2009.06.019
  30. Güvener O, Dağ F, Çimen ÖB, Özçakar L. Ultrasound assessment of distal femoral cartilage thickness measurements after walking/jogging in subjects with pes planus. Knee. 2022;39:161-167. doi: 10.1016/j.knee.2022.09.007
  31. Logerstedt DS, Ebert JR, MacLeod TD, Heiderscheit BC, Gabbett TJ, Eckenrode BJ. Effects of and response to mechanical loading on the knee. Sports Med. 2021;52(2):201-235. doi: 10.1007/s40279-021-01579-7
  32. Bedewi MA, Elsifey AA, Naguib MF, et al. Ultrasonographic measurement of femoral cartilage thickness in type II diabetic patients. Medicine. 2020;99(14):e19455. doi: 10.1097/md.0000000000019455
  33. Babayeva N, Dönmez G, Özçakar L, et al. Mean femoral cartilage thickness is higher in athletes as compared with sedentary individuals. Knee Surg Sports Traumatol Arthrosc. 2020;29(4):1206-1214. doi: 10.1007/s00167-020-06146-7
  34. Dreiner M, Munk T, Zaucke F, Liphardt AM, Niehoff A. Relationship between different serum cartilage biomarkers in the acute response to running and jumping in healthy male individuals. Sci Rep. 2022;12(1). doi: 10.1038/s41598-022-11194-9
  35. Mündermann A, Dyrby CO, Andriacchi TP, King KB. Serum concentration of cartilage oligomeric matrix protein (COMP) is sensitive to physiological cyclic loading in healthy adults. Osteoarthr Cartil. 2005;13(1):34-38. doi: 10.1016/j.joca.2004.09.007
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