Quadriceps strength and osteoarthritis progression in malaligned and lax knees - PubMed (original) (raw)
Quadriceps strength and osteoarthritis progression in malaligned and lax knees
Leena Sharma et al. Ann Intern Med. 2003.
Abstract
Background: Quadriceps muscle strengthening is a common goal in the management of knee osteoarthritis. In healthy knees, strength protects against new osteoarthritis. In arthritic knees, greater strength may protect joints and thereby delay osteoarthritis progression. Alternatively, in certain joint environments, such as malalignment or laxity, greater strength may translate into damaging joint reaction forces. The relationship between quadriceps strength and progression of knee osteoarthritis may differ according to these factors.
Objective: To determine whether greater quadriceps strength is associated with greater probability of tibiofemoral osteoarthritis progression in malaligned knees and in high-laxity knees.
Design: Prospective, longitudinal cohort study.
Setting: Academic medical center.
Participants: 237 persons with primary knee osteoarthritis, definite tibiofemoral osteophytes, and at least some difficulty with knee-requiring activity. Two hundred thirty completed the 18-month evaluation. The current study primarily involved those without advanced osteoarthritis in either knee (n = 171).
Measurements: Quadriceps strength, knee laxity and alignment, and osteoarthritis progression.
Results: The predicted probability of tibiofemoral progression was 0.153 (95% CI, 0.100 to 0.228) in high-strength knees and 0.098 (CI, 0.061 to 0.155) in low-strength knees. In malaligned knees, high strength was associated with a significant increase (P = 0.03) in the likelihood of progression (predicted probability, 0.406 [CI, 0.226 to 0.615] vs. 0.187 [CI, 0.081 to 0.375] in high-strength vs. low-strength knees). Strength was also associated with increased likelihood of progression in high-laxity knees (P = 0.003 when high laxity was defined as > or =6.75 degrees). The probability of patellofemoral progression did not differ between high- and low-strength knees in the full sample or within subsets.
Conclusions: Greater quadriceps strength at baseline was associated with increased likelihood of tibiofemoral osteoarthritis progression in malaligned knees and lax knees. Subset-specific approaches beyond strengthening exercises should be developed to enhance joint-protective muscle activity.
Comment in
- Is a strong quadriceps muscle bad for a patient with knee osteoarthritis?
Brandt KD. Brandt KD. Ann Intern Med. 2003 Apr 15;138(8):678-9. doi: 10.7326/0003-4819-138-8-200304150-00017. Ann Intern Med. 2003. PMID: 12693892 No abstract available. - Quadriceps strength and osteoarthritis progression in malaligned and lax knees.
Moore ME. Moore ME. Ann Intern Med. 2004 Jan 20;140(2):149; author reply 150. doi: 10.7326/0003-4819-140-2-200401200-00027. Ann Intern Med. 2004. PMID: 14734347 No abstract available. - Quadriceps strength and osteoarthritis progression in malaligned and lax knees.
Judge J. Judge J. Ann Intern Med. 2004 Jan 20;140(2):149; author reply 150. doi: 10.7326/0003-4819-140-2-200401200-00026. Ann Intern Med. 2004. PMID: 14734348 No abstract available. - Quadriceps strength and osteoarthritis progression in malaligned and lax knees.
Riley D. Riley D. Ann Intern Med. 2004 Jan 20;140(2):149. doi: 10.7326/0003-4819-140-2-200401200-00028. Ann Intern Med. 2004. PMID: 14734349 No abstract available. - Quadriceps strength as a predictor of knee osteoarthritis progression.
Hart LE. Hart LE. Clin J Sport Med. 2004 Mar;14(2):104-5. doi: 10.1097/00042752-200403000-00012. Clin J Sport Med. 2004. PMID: 15014348 No abstract available.
Summary for patients in
- Summaries for patients. Upper leg muscle strength and osteoarthritis.
[No authors listed] [No authors listed] Ann Intern Med. 2003 Apr 15;138(8):I1. doi: 10.7326/0003-4819-138-8-200304150-00001. Ann Intern Med. 2003. PMID: 12693914 No abstract available.
Similar articles
- Tibiofemoral Osteoarthritis and Varus-Valgus Laxity.
Freisinger GM, Schmitt LC, Wanamaker AB, Siston RA, Chaudhari AMW. Freisinger GM, et al. J Knee Surg. 2017 Jun;30(5):440-451. doi: 10.1055/s-0036-1592149. Epub 2016 Sep 28. J Knee Surg. 2017. PMID: 27680888 Free PMC article. Review. - Quadriceps strength and osteoarthritis progression in malaligned and lax knees.
Riley D. Riley D. Ann Intern Med. 2004 Jan 20;140(2):149. doi: 10.7326/0003-4819-140-2-200401200-00028. Ann Intern Med. 2004. PMID: 14734349 No abstract available. - Quadriceps strength and osteoarthritis progression in malaligned and lax knees.
Moore ME. Moore ME. Ann Intern Med. 2004 Jan 20;140(2):149; author reply 150. doi: 10.7326/0003-4819-140-2-200401200-00027. Ann Intern Med. 2004. PMID: 14734347 No abstract available. - Quadriceps strength and osteoarthritis progression in malaligned and lax knees.
Judge J. Judge J. Ann Intern Med. 2004 Jan 20;140(2):149; author reply 150. doi: 10.7326/0003-4819-140-2-200401200-00026. Ann Intern Med. 2004. PMID: 14734348 No abstract available. - Meta-analysis on the association between knee extensor strength and structural changes of knee osteoarthritis.
Hou X, Yang G. Hou X, et al. Clin Rheumatol. 2021 Sep;40(9):3511-3521. doi: 10.1007/s10067-021-05634-6. Epub 2021 Feb 24. Clin Rheumatol. 2021. PMID: 33624181 Review.
Cited by
- Aerobic activity in prevention and symptom control of osteoarthritis.
Semanik PA, Chang RW, Dunlop DD. Semanik PA, et al. PM R. 2012 May;4(5 Suppl):S37-44. doi: 10.1016/j.pmrj.2012.02.015. PM R. 2012. PMID: 22632701 Free PMC article. Review. - Tibiofemoral Osteoarthritis and Varus-Valgus Laxity.
Freisinger GM, Schmitt LC, Wanamaker AB, Siston RA, Chaudhari AMW. Freisinger GM, et al. J Knee Surg. 2017 Jun;30(5):440-451. doi: 10.1055/s-0036-1592149. Epub 2016 Sep 28. J Knee Surg. 2017. PMID: 27680888 Free PMC article. Review. - Moderators of the effects of therapeutic exercise for people with knee and hip osteoarthritis: A systematic review of sub-group analyses from randomised controlled trials.
Quicke JG, Runhaar J, van der Windt DA, Healey EL, Foster NE, Holden MA. Quicke JG, et al. Osteoarthr Cartil Open. 2020 Nov 4;2(4):100113. doi: 10.1016/j.ocarto.2020.100113. eCollection 2020 Dec. Osteoarthr Cartil Open. 2020. PMID: 36474874 Free PMC article. Review. - Pathogenesis and clinical management of obesity-related knee osteoarthritis: Impact of mechanical loading.
Chen L, Zheng JJY, Li G, Yuan J, Ebert JR, Li H, Papadimitriou J, Wang Q, Wood D, Jones CW, Zheng M. Chen L, et al. J Orthop Translat. 2020 May 15;24:66-75. doi: 10.1016/j.jot.2020.05.001. eCollection 2020 Sep. J Orthop Translat. 2020. PMID: 32695606 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Miscellaneous