Quadriceps strength is negatively associated with knee joint structural abnormalities—data from osteoarthritis initiative

Abstract

Objective The aim of this study was to explore the longitudinal associations between baseline quadriceps strength and knee joint structural abnormalities in knee osteoarthritis (KOA). Methods This study is a longitudinally observational study based on Osteoarthritis Initiative (OAI) cohort, including men and women aged 45–79. Quadriceps strength was measured by isometric knee extension testing at baseline. Knee joint structural abnormalities, including cartilage damage, bone marrow lesions (BMLs), effusion-synovitis and Hoffa-synovitis, were evaluated by Magnetic Resonance Imaging Osteoarthritis Knee Score (MOAKS) at baseline and 1-year follow-up. Generalized estimating equations were employed to examine the associations between quadriceps strength and knee structural abnormalities. All analyses were stratified by sex. Results One thousand three hundred thirty-eight participants (523 men and 815 women) with a mean age of 61.8 years and a mean BMI of 29.4 kg/m2 were included in this study. For men, no significantly longitudinal association of quadriceps strength with structural abnormalities was detected. In contrast, quadriceps strength was significantly and negatively associated with changes in cartilage damage and BMLs in lateral patellofemoral joint (PFJ) (cartilage damage: OR: 0.91, 95% CI 0.84 to 0.99, P = 0.023; BMLs: OR: 0.85, 95% CI 0.74 to 0.96, P = 0.011) and effusion-synovitis (OR = 0.88, 95% CI 0.78 to 0.99, P = 0.045) among females longitudinally. Higher quadriceps strength was significantly associated with less progression of lateral PFJ cartilage damage, BMLs and effusion-synovitis in females. Conclusions Higher quadriceps strength was associated with changes in cartilage damage and BMLs within the lateral PFJ and effusion-synovitis among females, suggesting the potential protective role of quadriceps strength on joint structures in women.

Quadriceps Muscle Mechanics and Knee Osteoarthritis - A 2022 Update

“…To further complicate the data outcomes and inferences highlighted to date, research by Gong, et al, show gender variations in quadriceps strength and its association with structural abnormalities at the knee that imply more gender based sub group studies are indicated [82]. In addition, the effects of knee extensor muscle weakness may impact knee cartilage sites differentially according to Xu, et al sites that could be affected by osteoarthritis, and only studying selected joint sites may surely lead to erroneous conclusions [83].…”

“…Indeed, it seems current and past results do imply osteoarthritis quadriceps femoris associated forms of dysfunction do prevail quite consistently in general, but what is reported and what emerges from the various research offerings reflect what muscle attribute is assessed, as well as what disease indicator is studied, or how much muscle fat mass prevails, rather than any overriding 'law' or unified framework of influence [84]. As well, emergent results may depend on the magnitude as well as the type of knee osteoarthritis studied, as well as how and what measurement instruments and analyses are applied or conducted, and their temporal sequence [82]. Tung, et al, further imply that it is measures of muscle capacity utilization, while not found to be associated with pain during walking among a sample of adults with knee osteoarthritis, that is a potentially unreported or unexplored realm of possible relevance that should yet be explored further in the future because current tests failed to employ one or more challenging activities of daily living in their mobility test paradigm that might reveal considerable and novel insights [85].…”