{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T14:24:48Z","timestamp":1761402288530,"version":"build-2065373602"},"reference-count":82,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Caja Rural Soria"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Osteoarthritis is a disorder affecting the joints and is characterized by cellular stress and degradation of the extracellular matrix cartilage. It begins with the presence of micro- and macro-lesions that fail to repair properly, which can be initiated by multiple factors: genetic, developmental, metabolic, and traumatic. In the case of the knee, osteoarthritis affects the tissues of the diarthrodial joint, manifested by morphological, biochemical, and biomechanical modifications of the cells and the extracellular matrix. All this leads to remodeling, fissuring, ulceration, and loss of articular cartilage, as well as sclerosis of the subchondral bone with the production of osteophytes and subchondral cysts. The symptomatology appears at different time points and is accompanied by pain, deformation, disability, and varying degrees of local inflammation. Repetitive concentric movements, such as while cycling, can produce the microtrauma that leads to osteoarthritis. Aggravation of the gradual lesion in the cartilage matrix can evolve to an irreversible injury. The objective of the present review is to explain the evolution of knee osteoarthritis in cyclists, to show the scarce research performed in this particular field and extract recommendations to propose future therapeutic strategies.<\/jats:p>","DOI":"10.3390\/jcm12113703","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T16:17:33Z","timestamp":1685204253000},"page":"3703","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Inflammatory Process on Knee Osteoarthritis in Cyclists"],"prefix":"10.3390","volume":"12","author":[{"given":"David","family":"Noriega-Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, HVUV, 47003 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9131-0615","authenticated-orcid":false,"given":"Alberto","family":"Caballero-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Radiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5128-1672","authenticated-orcid":false,"given":"Enrique","family":"Roche","sequence":"additional","affiliation":[{"name":"Department of Applied Biology-Nutrition and Institute of Bioengineering, Miguel Hern\u00e1ndez University (UMH), 03202 Elche, Spain"},{"name":"Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain"},{"name":"CIBER Fisiopatolog\u00eda de la Obesidad y la Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1309-7510","authenticated-orcid":false,"given":"Melchor","family":"\u00c1lvarez-Mon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Alcal\u00e1 de Henares, 28801 Alcal\u00e1 de Henares, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0236-2817","authenticated-orcid":false,"given":"Alfredo","family":"C\u00f3rdova","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Duques de Soria, 42004 Soria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1136\/bmj.332.7542.639","article-title":"Osteoarthritis","volume":"332","author":"Hunter","year":"2006","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"C\u00f3rdova-Mart\u00ednez, A., Caballero-Garc\u00eda, A., Bello, H.J., Perez-Valdecantos, D., and Roche, E. (2022). Effects of Eccentric vs. Concentric Sports on Blood Muscular Damage Markers in Male Professional Players. Biology, 11.","DOI":"10.3390\/biology11030343"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1080\/02640410500141158","article-title":"Effects of AM3 (Inmunoferon) on increased serum concentrations of interleukin-6 and tumour necrosis factor receptors I and II in cyclists","volume":"24","author":"Monserrat","year":"2006","journal-title":"J. Sport. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"207","DOI":"10.2165\/00007256-198907040-00001","article-title":"Exercise-induced muscle damage and adaptation","volume":"7","author":"Ebbeling","year":"1989","journal-title":"Sport. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/S0014-2999(03)01285-8","article-title":"Neuroendocrine pharmacology of stress","volume":"463","author":"Carrasco","year":"2003","journal-title":"Eur. J. Pharmacol."},{"key":"ref_6","first-page":"450","article-title":"Case report: Professional cyclist diagnosed osteoarthritis of the knee grade II","volume":"9","year":"2020","journal-title":"Clin. Case Rep."},{"key":"ref_7","first-page":"261","article-title":"Macrophages in osteoarthritis: Pathophysiology and therapeutics","volume":"12","author":"Chen","year":"2020","journal-title":"Am. J. Trans. Res."},{"key":"ref_8","first-page":"11","article-title":"Mecanismos etiopatog\u00e9nicos de la artrosis","volume":"28","author":"Oteo","year":"2021","journal-title":"Rev. Soc. Esp. Dolor"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.reuma.2020.01.008","article-title":"Prevalence of symptomatic osteoarthritis in Spain: EPISER2016 study","volume":"17","author":"Blanco","year":"2020","journal-title":"Reumatol. Clin."},{"key":"ref_10","first-page":"210215","article-title":"Biom\u00e9canique du genou du cycliste","volume":"81","author":"Haushalter","year":"1987","journal-title":"M\u00e9d. Sport"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.1097\/JSA.0000000000000226","article-title":"Preservation of Knee Articular Cartilage","volume":"26","author":"Redondo","year":"2018","journal-title":"Sport. Med. Arthrosc. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1002\/1529-0131(200009)43:9<1916::AID-ANR2>3.0.CO;2-I","article-title":"The role of the chondrocyte in osteoarthritis","volume":"43","author":"Goldring","year":"2000","journal-title":"Arthritis Rheum."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/S0049-0172(96)80036-9","article-title":"Cytokines in osteoarthritis: Mediators or markers of joint destruction?","volume":"25","author":"Westacott","year":"1996","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.rehab.2016.01.006","article-title":"Risk factors and burden of osteoarthritis","volume":"59","author":"Palazzo","year":"2016","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_15","first-page":"152","article-title":"The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee","volume":"107","author":"Michael","year":"2010","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.berh.2005.09.007","article-title":"Osteoarthritis: Epidemiology","volume":"20","author":"Arden","year":"2006","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1038\/nrrheum.2012.224","article-title":"Tackling obesity in knee osteoarthritis","volume":"9","author":"Wluka","year":"2013","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_18","first-page":"205","article-title":"Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I","volume":"2","author":"Heidari","year":"2011","journal-title":"Casp. J. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6093","DOI":"10.3390\/ijms16036093","article-title":"Osteoarthritis in the XXIst century: Risk factors and behaviours that influence disease onset and progression","volume":"16","author":"Musumeci","year":"2015","journal-title":"Int. J. Mol. Sci."},{"key":"ref_20","first-page":"602","article-title":"Polymorphisms in the Growth Differentiation Factor 5 (GDF 5) Gene in Knee Osteoarthritis","volume":"27","author":"Ozcan","year":"2017","journal-title":"J. Coll. Phys. Surg. Pak."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/S1138-3593(04)74307-5","article-title":"Protocolo de valoraci\u00f3n de la patolog\u00eda de la rodilla","volume":"30","author":"Vergara","year":"2004","journal-title":"SEMERGEN"},{"key":"ref_22","first-page":"CD004522","article-title":"Thermotherapy for treatment of osteoarthritis","volume":"2003","author":"Brosseau","year":"2003","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Reginster, J.Y., Pelletier, J.P., Martel-Pelletier, J., and Henrotin, Y. (1999). Osteoarthritis: Clinical and Experimental Aspects, Springer.","DOI":"10.1007\/978-3-642-60026-5"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1177\/0363546515575023","article-title":"Stimulation of the superficial zone protein and lubrication in the articular cartilage by human platelet-rich plasma","volume":"43","author":"Sakata","year":"2015","journal-title":"Am. J. Sport. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2680","DOI":"10.1002\/art.27577","article-title":"Increased friction coefficient and superficial zone protein expression in patients with advanced osteoarthritis","volume":"62","author":"Neu","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jmbbm.2013.03.019","article-title":"Microscale surface friction of articular cartilage in early osteoarthritis","volume":"25","author":"Desrochers","year":"2013","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.bone.2012.02.012","article-title":"The role of synovitis in osteoarthritis pathogenesis","volume":"51","author":"Scanzello","year":"2012","journal-title":"Bone"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.coph.2015.03.004","article-title":"Emerging targets in osteoarthritis therapy","volume":"22","author":"Goldring","year":"2015","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1186\/ar2592","article-title":"Cartilage homeostasis in health and rheumatic diseases","volume":"11","author":"Goldring","year":"2009","journal-title":"Arthritis Res. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1038\/nrrheum.2010.196","article-title":"Role of proinflammatory cytokines in the pathophysiology of osteoarthritis","volume":"7","author":"Kapoor","year":"2010","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1038\/nrrheum.2010.159","article-title":"The role of synovitis in pathophysiology and clinical symptoms of osteoarthritis","volume":"6","author":"Sellam","year":"2010","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1002\/art.27290","article-title":"The role of synovial macrophages and macrophage-produced mediators in driving inflammatory and destructive responses in osteoarthritis","volume":"62","author":"Bondeson","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1097\/BOR.0b013e328349c2b1","article-title":"Inflammation in osteoarthritis","volume":"23","author":"Goldring","year":"2011","journal-title":"Curr. Op. Rheumatol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Molnar, V., Mati\u0161i\u0107, V., Kodvanj, I., Bjelica, R., Jele\u010d, \u017d., Hudetz, D., Rod, E., \u010cukelj, F., Vrdoljak, T., and Vidovi\u0107, D. (2021). Cytokines and Chemokines Involved in Osteoarthritis Pathogenesis. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22179208"},{"key":"ref_35","first-page":"75","article-title":"Chondrocytes apoptosis induced by nitric oxide","volume":"146","author":"Blanco","year":"1995","journal-title":"Am. J. Pathol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2637","DOI":"10.1002\/art.10518","article-title":"The in situ up-regulation of chondrocyte interleukin-1-converting enzyme and interleukin-18 levels in experimental osteoarthritis is mediated by nitric oxide","volume":"46","author":"Boileau","year":"2002","journal-title":"Arthritis Rheum."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1053\/joca.1998.0216","article-title":"Nitric oxide in osteoarthritis","volume":"7","author":"Studer","year":"1999","journal-title":"Osteoarthr. Cartil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1016\/S1063-4584(08)60008-4","article-title":"Osteoarthritis and nitric oxide","volume":"16","author":"Abramson","year":"2008","journal-title":"Osteoarthr. Cartil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/S1090-0233(02)00331-3","article-title":"Apoptosis and the loss of chondrocyte survival signals contribute to articular cartilage degradation in osteoarthritis","volume":"166","author":"Goggs","year":"2003","journal-title":"Vet. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1002\/art.10837","article-title":"Mitochondrial respiratory activity is altered in osteoarhritic human articular chondrocytes","volume":"48","author":"Maneiro","year":"2003","journal-title":"Arthritis Rheum."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1002\/1529-0131(200106)44:6<1237::AID-ART214>3.0.CO;2-F","article-title":"Osteoarthritis, an inflammatory disease: Potential implication for the selection of new therapeutic targets","volume":"44","author":"Pelletier","year":"2001","journal-title":"Arthritis Rheum."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"R16","DOI":"10.1186\/ar2917","article-title":"S100A8 and S100A9 in experimental osteoarthritis","volume":"12","author":"Zreiqat","year":"2010","journal-title":"Arthritis Res. Ther."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.joca.2009.03.002","article-title":"Aging and osteoarthritis: The role of chondrocyte senescence and aging changes in the cartilage matrix","volume":"17","author":"Loeser","year":"2009","journal-title":"Osteoarthr. Cartil."},{"key":"ref_44","first-page":"7667","article-title":"Enrichment of inflammatory mediators in the synovial fluid is associated with slower progression of mild to moderate osteoarthritis in the porcine knee","volume":"13","author":"Karamchedu","year":"2021","journal-title":"Am. J. Transl. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1016\/j.joca.2012.07.021","article-title":"Cartilage and bone markers and inflammatory cytokines are increased in synovial fluid in the acute phase of knee injury (hemarthrosis)\u2014A cross-sectional analysis","volume":"20","author":"Sward","year":"2012","journal-title":"Osteoarthr. Cartil."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1002\/jor.23471","article-title":"Chemokines and inflammation in osteoarthritis: Insights from patients and animal models","volume":"35","author":"Scanzello","year":"2017","journal-title":"J. Orthop. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"11S","DOI":"10.1177\/1947603511415841","article-title":"Scientific evidence base for cartilage injury and repair in the athlete","volume":"3","author":"Steinwachs","year":"2012","journal-title":"Cartilage"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s10856-018-6066-0","article-title":"Zone-dependent mechanical properties of human articular cartilage obtained by indentation measurements","volume":"29","author":"Antons","year":"2018","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_49","first-page":"133","article-title":"Biomechanical properties of knee articular cartilage","volume":"40","author":"Laasanen","year":"2003","journal-title":"Biorheology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"9900","DOI":"10.1038\/s41598-018-27737-y","article-title":"Mesenchymal stem cells in combination with hyaluronic acid for articular cartilage defects","volume":"8","author":"Li","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1016\/j.joca.2018.08.009","article-title":"Cartilage-on-cartilage contact: Effect of compressive loading on tissue deformations and structural integrity of bovine articular cartilage","volume":"26","author":"Zevenbergen","year":"2018","journal-title":"Osteoarthr. Cartil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.coph.2016.02.009","article-title":"New developments in osteoarthritis and cartilage biology","volume":"28","author":"Poulet","year":"2016","journal-title":"Curr. Op. Pharmacol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"748","DOI":"10.5435\/00124635-200712000-00008","article-title":"Cycling injuries of the lower extremity","volume":"15","author":"Wanich","year":"2007","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"99","DOI":"10.2147\/OAJSM.S136653","article-title":"Potential factors associated with knee pain in cyclists: A systematic review","volume":"9","author":"Bini","year":"2018","journal-title":"Open Access J. Sport. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"119","DOI":"10.7196\/SAJSM.555","article-title":"Non-traumatic injury profile of amateur cyclists","volume":"26","author":"Fletcher","year":"2014","journal-title":"S. Afr. J. Sport. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/sms.12223","article-title":"The prevalence and impact of overuse injuries in five Norwegian sports: Application of a new surveil-lance method","volume":"25","author":"Clarsen","year":"2015","journal-title":"Scand. J. Med. Sci. Sport."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2494","DOI":"10.1177\/0363546510376816","article-title":"Overuse injuries in professional road cyclists","volume":"38","author":"Clarsen","year":"2010","journal-title":"Am. J. Sport. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"7","DOI":"10.2165\/00007256-200636010-00002","article-title":"Non-traumatic bicycle injuries\u2014A review of the literature","volume":"36","author":"Dettori","year":"2006","journal-title":"Sport. Med."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Winters, J.M., and Woo, S. (1990). Multiple Muscle Systems. Biomechanics and Movement Organisation, Springer.","DOI":"10.1007\/978-1-4613-9030-5"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.ptsp.2005.02.004","article-title":"Muscle recruitment pattern in cycling: A review","volume":"6","author":"So","year":"2005","journal-title":"Phys. Ther. Sport"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"479","DOI":"10.2165\/00007256-200131070-00003","article-title":"Physiological and performance characteristics of male professional road cyclists","volume":"31","author":"Mujika","year":"2001","journal-title":"Sport. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1177\/036354659602400608","article-title":"Predictors of injury among 1638 riders in a recreational long-distance bicycle tour: Cycle Across Maryland","volume":"24","author":"Dannenberg","year":"1996","journal-title":"Am. J. Sport. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1055\/s-2007-972992","article-title":"An epidemiological analysis of overuse injuries among recreational cyclists","volume":"16","author":"Wilber","year":"1995","journal-title":"Int. J. Sport. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"678","DOI":"10.2519\/jospt.2006.2305","article-title":"The use of neuromuscular electrical stimulation to improve activation deficits in a patient with chronic quadriceps strength impairments following total knee arthroplasty","volume":"36","author":"Petterson","year":"2006","journal-title":"J. Orthop. Sport. Phys. Ther."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"106380","DOI":"10.1016\/j.ijscr.2021.106380","article-title":"Unusual combination of posterior cruciate ligament tibial avulsion fracture and Segond fracture: A case report","volume":"86","author":"Phatama","year":"2021","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.knee.2021.01.026","article-title":"Does saddle height influence knee frontal-plane biomechanics during stationary cycling?","volume":"29","author":"Hummer","year":"2021","journal-title":"Knee"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Pinheiro, F.A., Pires, F.O., R\u00f8nnestad, B.R., Hardt, F., Concei\u00e7\u00e3o, M.S., Lixandr\u00e3o, M.E., Berton, R., and Tricoli, V. (2022). The Effect of Low-intensity Aerobic Training Combined with Blood Flow Restriction on Maximal Strength, Muscle Mass, and Cycling Performance in a Cyclist with Knee Displacement. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19052993"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1007\/s00167-016-4068-3","article-title":"Early osteoarthritis of the knee","volume":"24","author":"Madry","year":"2016","journal-title":"Knee Surg. Sport. Traumatol. Arthrosc."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1016\/j.ajpath.2011.05.023","article-title":"Intact pericellular matrix of articular cartilage is required for unactivated discoidin domain receptor 2 in the mouse model","volume":"179","author":"Xu","year":"2011","journal-title":"Am. J. Pathol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1519\/JSC.0b013e31828f1ee9","article-title":"Exercise intensity and recovery: Biomarkers of injury, inflammation and oxidative stress","volume":"30","author":"Bessa","year":"2013","journal-title":"J. Strength Cond. Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/B978-0-12-394317-0.00015-7","article-title":"Metabolic markers in sports medicine","volume":"56","author":"Banfi","year":"2012","journal-title":"Adv. Clin. Chem."},{"key":"ref_72","first-page":"165","article-title":"Hormonal adaptation and the stress of exercise training: The role of glucocorticoids","volume":"20","author":"Hackney","year":"2013","journal-title":"Trends Sport Sci."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1519\/JSC.0b013e3181ce2423","article-title":"Testosterone and cortisol changes in professional basketball players through a season competition","volume":"24","year":"2010","journal-title":"J. Strength Cond. Res."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"339","DOI":"10.2165\/00007256-200535040-00004","article-title":"Hormonal responses and adaptations to resistance exercise and training","volume":"35","author":"Kraemer","year":"2005","journal-title":"Sport. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"4270","DOI":"10.1016\/j.sjbs.2021.06.091","article-title":"MicroRNA-186 ameliorates Knee osteoarthritis via regulation of P2X7-mediated Cathepsin-K\/Runx2\/ADAMTS5 signalling axis in particular chondrocytes","volume":"28","author":"Deng","year":"2021","journal-title":"Saudi J. Biol. Sci."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1589\/jpts.27.1261","article-title":"Relationship between knee alignment and the electromyographic activity of quadriceps muscles in patients with knee osteoarthritis","volume":"27","author":"Lim","year":"2015","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"50","DOI":"10.2174\/1573397111666150522094131","article-title":"Inflammatory Pathways in Knee Osteoarthritis: Potential Targets for Treatment","volume":"11","author":"Rael","year":"2015","journal-title":"Curr. Rheumatol. Rev."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s10103-020-03124-w","article-title":"Does low level laser therapy has effects on inflammatory biomarkers IL-1\u03b2, IL-6, TNF-\u03b1, and MMP-13 in osteoarthritis of rat models-a systemic review and meta-analysis","volume":"36","author":"Nambi","year":"2021","journal-title":"Lasers Med. Sci."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.jpain.2019.01.034","article-title":"Interleukin-6 is associated with abdominal muscle growth in knee osteoarthritis patients","volume":"20","author":"Nguyen","year":"2019","journal-title":"J. Pain"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.12998\/wjcc.v7.i11.1262","article-title":"Elevated levels of interleukin-1\u03b2, interleukin-6, tumor necrosis factor-\u03b1 and vascular endothelial growth factor in patients with knee articular cartilage injury","volume":"7","author":"Wang","year":"2019","journal-title":"World J. Clin. 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