Stage-dependent effects of moderate treadmill exercise on cartilage preservation and subchondral bone remodeling in mouse osteoarthritis progression.

Objective: Exercise is widely advocated for osteoarthritis (OA) treatment; however, its effectiveness across disease stages, particularly in advanced OA, remains inconclusive. This study assessed the impact of treadmill exercise at distinct OA stages to determine optimal intervention timing.

Methods: Following validation of a moderate treadmill protocol, 96 male C57BL/6J mice underwent destabilization of the medial meniscus (DMM) surgery on the right knee and sham surgery on the left. Mice were randomly assigned to sedentary (SED) or treadmill exercise (RUN) groups, starting at 3 days, 4, 8, or 12 weeks postoperatively. At each timepoint, bilateral knees were analyzed by micro-computed tomography, histo-morphometry, immunohistochemistry, and osteoblast/osteoclast function.

Results: Exercise initiated 3-day post-surgery preserved cartilage integrity (median OARSI: 1.0 in RUN vs. 2.0 in SED) and reduced subchondral bone (SB) lesions (BV/TV: 76.6% in RUN vs. 81.8% in SED) and osteophyte volume (0.015 mm³ in RUN vs. 0.026 mm³ in SED). At four weeks, articular cartilage thickness remained higher in exercised joints (86.1 μm in RUN vs. 78.5 μm in SED), though SB deterioration and osteophyte formation persisted. By eight weeks, exercise exacerbated articular cartilage degeneration (41.5 μm in RUN vs. 62.3 μm in SED). At twelve weeks, further deterioration was observed, including reduced calcified cartilage cellularity and increased SB thickness (541.9 μm in RUN vs. 519.4 μm in SED), suggesting delayed exercise may worsen joint pathology.

Conclusions: Treadmill exercise offers protective effects when initiated early after OA onset but may worsen outcomes if delayed. Tailored exercise protocols based on disease stage are essential for optimal OA management.