Quadriceps Weakness in Individuals with Coexisting Medial and Lateral Osteoarthritis

Abstract

Background: This study examined whether individuals who have mild medial osteoarthritis (OA) of the knee with coexisting lateral OA have less muscle strength than individuals who do not have lateral OA. Methods: A series of 153 individuals (84% of whom were women) between 48 and 88 years old who had Kellgren and Lawrence (KL) grade-2 OA in the medial compartment of the knee underwent radiographic evaluation to assess the presence of lateral OA, which was graded with the system of the Osteoarthritis Research Society International (OARSI) atlas as well as the KL system. The isometric maximum strengths of the quadriceps, the hip abductors, and the hip extensors were evaluated with use of a handheld dynamometer. Results: Individuals who had coexisting medial and lateral OA had more severe knee pain and weaker quadriceps than those who did not have lateral OA. The study adjusted for age and sex both for the OARSI atlas system (adjusted difference in mean strength: 0.272 Nm/kg, 95% confidence interval [CI]: 0.143 to 0.401 Nm/kg) and for KL grading (adjusted difference in mean strength: 0.185 Nm/kg, 95% CI: 0.061 to 0.309 Nm/kg). Logistic regression analysis showed that weakness of the quadriceps increased the odds of the presence of lateral OA sevenfold after adjustments using the OARSI atlas were made for age, sex, anatomical axis, range of motion of the knee, and intensity of pain in the knee. Conclusions: Individuals who had coexisting medial and lateral OA had weaker quadriceps than individuals who had mild medial OA alone. Paying close attention to quadriceps weakness might provide a key to clarifying the pathogenesis of bicompartmental disease in the tibiofemoral joint. Level of Evidence: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Isokinetic training of lower extremity during the early stage promote functional restoration in elder patients with disability after Total knee replacement (TKR) - a randomized control trial

“…Hicks et al indicated that knee pain accompanied by decreased knee extension strength and standing balance was significantly correlated with the risk of multiple falls in older people [ 5 ]. Patients with OA knee frequently presented progressive knee pain and quadriceps weakness [ 6 ], and these problems can even be exacerbated during the early stage following TKR [ 7 ]. These factors will increase the risk of falling during early stage.…”

Acute Effect of Kinesiology Taping on Muscle Activation, Functionality and Proprioception in Patients With Knee Osteoarthritis: A Randomized Controlled Trial

“…Proprioceptive sensitivity attributable to fibrous capsules in skeletal muscles, tendons, and joints decreases in knee OA due to the degenerative changes of these structures (Jeong et al, 2019). It has also been emphasized that quadriceps muscle weakness, one of the most important findings of knee OA, may result from disuse atrophy due to pain, which is one of the symptoms of OA (Iijima et al, 2019). Furthermore, quadriceps strength loss may be a risk factor in the further development and progression of knee OA, based on the fact that quadriceps muscle strength affects OA symptoms, such as pain and loss of function (Onwunzo et al, 2021).…”