87 patients with Kellgren-Lawrence grade I-II knee osteoarthritis were randomized to 16-weeks of aquatic progressive resistance training (PRT) or were asked to maintain their current level of activity. The purpose of this study was to compare the change in T2 relaxation time on MRI and dGEMRIC index after 4 months, as well as knee extension and flexion strength and patient-reported outcome on the Knee Injury and Osteoarthritis Outcome Score (KOOS). The only significant differences between groups noted occurred at the posterior portion of the medial femoral condyle, with significantly greater reductions in T2 relaxation time and dGEMRIC index observed in the aquatic PRT group compared to the control group. All other assessments at the anterior and central medial femoral condyle, and anterior, central, and posterior lateral femoral condyle, demonstrated non-significant group differences. Changes in strength and patient-reported outcome also did not significantly differ between groups, however, there was a significantly greater increase in cardiorespiratory fitness in the training group.