Altered hamstring-quadriceps muscle balance in patients with knee osteoarthritis

Hortobágyi, Tibor; Westerkamp, Lenna M.; Beam, Stacey; Moody, Jill; Garry, Joseph P.; Holbert, Donald; DeVita, Paul

doi:10.1016/j.clinbiomech.2004.08.004

Cited by 189 publications

(156 citation statements)

References 31 publications

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“…These results suggest that muscle strength is required for successful joint stabilization and maintenance of physical functioning. A large body of literature exists demonstrating altered walking patterns (e.g., higher quadriceps and hamstrings activation and less knee excursion) in knee OA patients (3,(5)(6)(7)(8)(9)(10)(11)(12)(13), presumably as a strategy to stabilize the knee joint despite impairments in proprioceptive accuracy and laxity. These altered walking patterns further suggest a key role of the muscles in maintaining knee stability.…”

Section: Knoop Et Almentioning

confidence: 99%

“…Knee OA patients reporting knee instability have more severe activity limitations (2,4) than knee OA patients without this sensation. Self-reported knee instability has been linked to higher pain levels (1), higher rates of falling (1), and altered walking patterns (3,(5)(6)(7)(8)(9)(10)(11)(12)(13), and has been suggested to be a cause of knee OA onset and progression (7,13). Causes of knee instability are still unknown and need to be identified.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of lower muscle strength with self‐reported knee instability in osteoarthritis of the knee: Results from the Amsterdam Osteoarthritis Cohort

Knoop¹,

Leeden²,

Esch³

et al. 2011

Arthritis Care & Research

106

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Objective. To determine whether muscle strength, proprioceptive accuracy, and laxity are associated with self-reported knee instability in a large cohort of knee osteoarthritis (OA) patients, and to investigate whether muscle strength may compensate for impairment in proprioceptive accuracy or laxity, in order to maintain knee stability. Methods. Data from 283 knee OA patients from the Amsterdam Osteoarthritis cohort were used. Univariable and multivariable logistic regression analyses were performed to assess the association between muscle strength, proprioceptive accuracy (motion sense), frontal plane varus-valgus laxity, and self-reported knee instability. Additionally, effect modification between muscle strength and proprioceptive accuracy and between muscle strength and laxity was determined. Results. Self-reported knee instability was present in 67% of the knee OA patients and mainly occurred during walking. Lower muscle strength was significantly associated with the presence of self-reported knee instability, even after adjusting for relevant confounding. Impaired proprioceptive accuracy and high laxity were not associated with self-reported knee instability. No effect modification between muscle strength and proprioceptive accuracy or laxity was found. Conclusion. Lower muscle strength is strongly associated with self-reported knee instability in knee OA patients, while impairments in proprioceptive accuracy and laxity are not. A compensatory role of muscle strength for impaired proprioceptive accuracy or high laxity, in order to stabilize the knee, could not be demonstrated.

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Section: Knoop Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of lower muscle strength with self‐reported knee instability in osteoarthritis of the knee: Results from the Amsterdam Osteoarthritis Cohort

Knoop¹,

Leeden²,

Esch³

et al. 2011

Arthritis Care & Research

106

View full text Add to dashboard Cite

show abstract

“…Objectively, there is a loss of articular cartilage, visible as a narrowing of the joint space, particularly at the medial side (Hunter et al, 2009), and often accompanied by varus alignment. Other structures are also involved, and clinical investigation often reveals laxity of the knee joint (Lewek et al, 2004) and/or quadriceps weakness (Hortobágyi et al, 2005). Patients with knee pain (Heiden et al, 2009), or effusion (Torry et al, 2000), may alter their muscle activity, as do patients who feel unstable during gait (Schmitt and Rudolph, 2008).…”

Section: Introductionmentioning

confidence: 99%

“…Over the last decade, muscle activation patterns in gait have drawn considerable attention in the knee osteoarthritis literature. It was often reported that patients co-contract longer, co-contract more, or have higher muscle activity during walking than controls (e.g., Benedetti et al, 1999;Briem et al, 2007;Childs et al, 2004;Heiden et al, 2009;Hortobágyi et al, 2005;Hubley-Kozey et al, 2006;Lewek et al, 2003;Rudolph et al, 2001;Schmitt and Rudolph, 2007;Zeni et al, 2009). …”

Section: Introductionmentioning

confidence: 99%

Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

Fallah-Yakhdani¹,

Bafghi²,

Meijer³

et al. 2012

Clinical Biomechanics

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Background: Knee osteoarthritis patients co-contract in knee-related muscle pairs during walking. The determinants of this co-contraction remain insufficiently clear. Methods: A heterogeneous group of 14 patients was measured before and one year after knee arthroplasty, and compared to 12 healthy peers and 15 young subjects, measured once. Participants walked on a treadmill at several imposed speeds. Bilateral activity of six muscles was registered electromyographically, and cocontraction time was calculated as percentage of stride cycle time. Local dynamic stability and variability of sagittal plane knee movements were determined. The surgeon's assessment of alignment was used. Preoperatively, multivariate regressions on co-contraction time were used to identify determinants of cocontraction. Post-operatively it was assessed if predictor variables had changed in the same direction as co-contraction time. Findings: Patients co-contracted longer than controls, but post-operatively, differences with the healthy peers were no longer significant. Varus alignment predicted co-contraction time. No patient had post-operative varus alignment. The patients' unaffected legs were more unstable, and instability predicted co-contraction time in both legs. Post-operatively, stability normalised. Longer unaffected side co-contraction time was associated with reduced affected side kinematic variability. Post-operatively, kinematic variability had further decreased. Interpretations: Varus alignment and instability are determinants of co-contraction. The benefits of cocontraction in varus alignment require further study. Co-contraction probably increases local dynamic stability, which does not necessarily decrease the risk of falling. Unaffected side co-contraction contributed to decreasing affected side variability, but other mechanisms than co-contraction may also have played a role in decreasing variability.

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“…Doorenbosch and Harlaar showed that there is increased cocontraction in patients with lesions of the anterior cruciate ligament as compared with healthy control subjects (2). Likewise, differences in muscle activity patterns, including significant increases in co-contraction, have been reported during walking in patients with OA of the knee when compared with age-and sex-matched controls (3,4). We believe that Lewek et al rightly conclude that antagonist muscle co-contraction is used to stabilize the knee joint in the absence of adequate stabilization by the passive restraint system (ligaments and capsule) of the knee.…”

Section: To the Editormentioning

confidence: 73%

The pros and cons of muscle co‐contraction in osteoarthritis of the knee: Comment on the article by Lewek et al

Steultjens¹,

Dekker²

2006

Arthritis & Rheumatism

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Altered hamstring-quadriceps muscle balance in patients with knee osteoarthritis

Cited by 189 publications

References 31 publications

Association of lower muscle strength with self‐reported knee instability in osteoarthritis of the knee: Results from the Amsterdam Osteoarthritis Cohort

Association of lower muscle strength with self‐reported knee instability in osteoarthritis of the knee: Results from the Amsterdam Osteoarthritis Cohort

Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

The pros and cons of muscle co‐contraction in osteoarthritis of the knee: Comment on the article by Lewek et al

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