Role of thigh muscle cross-sectional area and strength in progression of knee cartilage degeneration over 48 months – data from the Osteoarthritis Initiative

Abstract

Objective To determine in a 48-month longitudinal study the association of thigh muscle cross-sectional area (CSA) and strength on progression of morphologic knee cartilage degeneration using 3T magnetic resonance imaging (MRI). Design Seventy Osteoarthritis Initiative (OAI) subjects aged 50-60 years, with no radiographic evidence of osteoarthritis (OA) and constant muscle strength over 48 months as measured by isometric knee extension testing were included. Baseline right thigh muscle CSAs were assessed on axial T1-weighted MR images, and extensor to flexor CSA ratios were calculated. Degenerative knee abnormalities at baseline and 48-months were graded on right knee 3T MRIs using a modified whole organ MRI score (WORMS). Statistical analysis employed Student's t-tests and multivariable regression models adjusted for age, body mass index and gender. Results Extension strength was significantly and positively correlated with baseline thigh muscle CSA (r=0.65, p<0.001). Greater baseline total thigh muscle CSA was significant associated with increase of cartilage WORMS scores over 48 months in patellar (p=0.027) and trochlear (p=0.038) compartments, but not in other knee compartments. Among specific muscle groups, CSA of extensors (p=0.021) and vastus medialis (VM) (p=0.047) were associated with patellar cartilage increase in WORMS. Baseline E/F ratio had a significant positive association with patellar WORMS cartilage score increase over 48 months, p=0.0015. There were no other significant associations between muscle CSA/ratios and increase in WORMS scores. Conclusion Maintenance of proper extensor to flexor muscle balance about the knee through decreased E/F ratios may slow patellofemoral cartilage deterioration, while higher extensor and VM CSA may increase patellofemoral cartilage loss.

Changes in the macroscopic morphology of hip muscles in low back pain

“…In addition, 46% of the included studies did not control the physical activity level as a potential confounding variable (Goldman et al. ) between the patients with LBP and asymptomatic participants. Therefore, the results of some included studies (Dangaria & Naesh, ; Arbanas et al.…”

“…Dangaria & Naesh (1998) demonstrated that there is a significant relationship between a reduction in the CSA of the psoas major muscle and the duration of continuous sciatica of the affected leg (Spearman's q = 0.8; P = 0.05). In addition, 46% of the included studies did not control the physical activity level as a potential confounding variable (Goldman et al 2016) between the patients with LBP and asymptomatic participants. Therefore, the results of some included studies (Dangaria & Naesh, 1998;Arbanas et al 2013;Abbas et al 2016;Hyun et al 2016;Singh et al 2016) could be confounded by this potentially important factor.…”

“…Stewart et al (2010) and Hides et al (2008) did not minimize the effect of age as another potential confounding variable in their studies, and the results were not presented after adjustment for age. Goldman et al (2016) stipulated that age may confound the estimates of muscle CSA. Pourahmadi et al (2018a) showed that patients with chronic non-specific LBP had limited lumbar spine and hip joints sagittal plane angles, and smaller angular velocity compared with asymptomatic individuals during a functional task.…”

International patellofemoral osteoarthritis consortium: Consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment

“…It is therefore important to include a skyline view X-ray in order to detect osteophytes and joint space narrowing of the PF joint. In a recent systematic review of studies evaluating the prevalence of radiographic PF OA, it was found that most included studies used lateral and/or skyline views to define PF OA [12]. Some studies have used these two views in the supine position with the knee flexed to 45 degrees [10], while others have used weight bearing radiographs with 30 degrees of knee flexion for the lateral views and non-weight bearing skyline view radiographs with knees in 30 degrees flexion [4].…”

“…Possible risk factors for progressive loss of patellar cartilage were age, BMI and more severe pain scores at baseline. [62,63] There is also a suggestion that exercise is associated with less patellar cartilage deterioration [12,61]. Known risk factors for progression of OA (woman, age, BMI) have shown to be risk factors for progression of PF cartilage deterioration.…”