Does Thinner Cartilage Cause More Knee Pain?

Here’s a study that could be of interest, as it casts doubt on the relationship between cartilage loss and knee pain.

The researchers found that a thinning of cartilage was associated with only a modest increase in knee pain. The writeup was published in the Annals of the Rheumatic Diseases.

There were 600 subjects who either had, or were at risk of, osteoarthritis of the knee. MRIs were taken of their knees at the outset, after one year, and after two years, then the images were compared.

Loss of cartilage thickness was significantly associated with a small degree of worsening knee pain over 24 months.

David Felson, one of the researchers, did note that an “indirect path” exists between cartilage loss and knee pain. The relationship could be through nerve-rich structures, such as the synovium and bone marrow.

Good news, right?

My first inclination is to say: sort of.

I wonder if the condition of the cartilage is more significant than the thickness. If the cartilage is thinner, but is stiff enough to absorb shocks well, it seems logical that someone would not feel pain.

But, to be fair, there is good news here. The welcome implication is that you don’t have to restore your knee cartilage to normal for your pain to go away.