Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort

N. A. Segal; N. A. Glass; J. Torner; M. Yang; D. T. Felson; L. Sharma; M. Nevitt; C. E. Lewis

doi:10.1016/j.joca.2010.02.002

Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort

N. A. Segal^*, N. A. Glass, J. Torner, M. Yang, D. T. Felson, L. Sharma, M. Nevitt, C. E. Lewis

^*Corresponding author for this work

Medicine, Rheumatology Division

Research output: Contribution to journal › Article › peer-review

186 Scopus citations

Abstract

Objective: Quadriceps weakness has been reported with incident but not progressive knee osteoarthritis (OA) in longitudinal studies. This study examined the relationship between quadriceps strength and worsening of knee joint space narrowing (JSN) over 30 months. Methods: Longitudinal, observational study of adults aged 50-79 years with OARSI JSN score <3 at baseline. Baseline measures included bilateral weight-bearing fixed flexion radiographs, isokinetic concentric quadriceps and hamstring strength, height and weight, and physical activity. Hamstring:quadriceps (H:Q) strength ratios also were evaluated. Worsening was defined as an increase in JSN score in the tibiofemoral and/or patellofemoral compartments on 30-month radiographs or total knee replacement. Knee-based analyses used generalized estimating equations, stratified by sex, to assess relationships between strength and knee JSN while controlling for covariance between knees within subjects as well as age, body mass index (BMI), history of knee injury and/or surgery, physical activity level and alignment. Results: 3856 knees (2254 females and 1602 males) with JSN score <3 at baseline and no missing follow-up data were included. Mean ± SD age was 62.2 ± 7.7 in women and 61.6 ± 8.1 in men. Women in the lowest tertile of quadriceps strength had an increased risk of whole knee JSN (OR=1.66, 95% CI =1.26, 2.19) and tibiofemoral JSN (OR=1.69, 95% CI=1.26, 2.28). However, no associations were found between strength and JSN in men or H:Q < 0.6 and JSN in men or women. Conclusions: In women but not in men, quadriceps weakness was associated with increased risk for tibiofemoral and whole knee JSN.

Original language	English (US)
Pages (from-to)	769-775
Number of pages	7
Journal	Osteoarthritis and Cartilage
Volume	18
Issue number	6
DOIs	https://doi.org/10.1016/j.joca.2010.02.002
State	Published - Jun 2010

Funding

Disclosures: This study was supported by NIH grants to: Boston University (David Felson, MD – AG18820 ); University of Iowa (James Torner, PhD – AG18832 ); University of Alabama (Cora E. Lewis, MD MSPH – AG18947 ); University of California San Francisco (Michael Nevitt, PhD – AG19069 ); and a Beeson Career Development Award (Neil Segal, MD – K23AG030945 ). The authors have no professional relationships with companies or manufacturers who will benefit from the results of the present study. An abstract of this data was presented at the 2008 annual meeting of the American College of Rheumatology.

Keywords

Hamstring:quadriceps ratio
Knee osteoarthritis
Quadriceps muscle strength
Rehabilitation

ASJC Scopus subject areas

Rheumatology
Biomedical Engineering
Orthopedics and Sports Medicine

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10.1016/j.joca.2010.02.002

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@article{a0dd6ce85eb54e518aa34ef6793b7bce,

title = "Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort",

abstract = "Objective: Quadriceps weakness has been reported with incident but not progressive knee osteoarthritis (OA) in longitudinal studies. This study examined the relationship between quadriceps strength and worsening of knee joint space narrowing (JSN) over 30 months. Methods: Longitudinal, observational study of adults aged 50-79 years with OARSI JSN score <3 at baseline. Baseline measures included bilateral weight-bearing fixed flexion radiographs, isokinetic concentric quadriceps and hamstring strength, height and weight, and physical activity. Hamstring:quadriceps (H:Q) strength ratios also were evaluated. Worsening was defined as an increase in JSN score in the tibiofemoral and/or patellofemoral compartments on 30-month radiographs or total knee replacement. Knee-based analyses used generalized estimating equations, stratified by sex, to assess relationships between strength and knee JSN while controlling for covariance between knees within subjects as well as age, body mass index (BMI), history of knee injury and/or surgery, physical activity level and alignment. Results: 3856 knees (2254 females and 1602 males) with JSN score <3 at baseline and no missing follow-up data were included. Mean ± SD age was 62.2 ± 7.7 in women and 61.6 ± 8.1 in men. Women in the lowest tertile of quadriceps strength had an increased risk of whole knee JSN (OR=1.66, 95% CI =1.26, 2.19) and tibiofemoral JSN (OR=1.69, 95% CI=1.26, 2.28). However, no associations were found between strength and JSN in men or H:Q < 0.6 and JSN in men or women. Conclusions: In women but not in men, quadriceps weakness was associated with increased risk for tibiofemoral and whole knee JSN.",

keywords = "Hamstring:quadriceps ratio, Knee osteoarthritis, Quadriceps muscle strength, Rehabilitation",

author = "Segal, {N. A.} and Glass, {N. A.} and J. Torner and M. Yang and Felson, {D. T.} and L. Sharma and M. Nevitt and Lewis, {C. E.}",

note = "Funding Information: Disclosures: This study was supported by NIH grants to: Boston University (David Felson, MD – AG18820 ); University of Iowa (James Torner, PhD – AG18832 ); University of Alabama (Cora E. Lewis, MD MSPH – AG18947 ); University of California San Francisco (Michael Nevitt, PhD – AG19069 ); and a Beeson Career Development Award (Neil Segal, MD – K23AG030945 ). The authors have no professional relationships with companies or manufacturers who will benefit from the results of the present study. An abstract of this data was presented at the 2008 annual meeting of the American College of Rheumatology.",

year = "2010",

month = jun,

doi = "10.1016/j.joca.2010.02.002",

language = "English (US)",

volume = "18",

pages = "769--775",

journal = "Osteoarthritis and Cartilage",

issn = "1063-4584",

publisher = "W.B. Saunders Ltd",

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T1 - Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort

AU - Segal, N. A.

AU - Glass, N. A.

AU - Torner, J.

AU - Yang, M.

AU - Felson, D. T.

AU - Sharma, L.

AU - Nevitt, M.

AU - Lewis, C. E.

N1 - Funding Information: Disclosures: This study was supported by NIH grants to: Boston University (David Felson, MD – AG18820 ); University of Iowa (James Torner, PhD – AG18832 ); University of Alabama (Cora E. Lewis, MD MSPH – AG18947 ); University of California San Francisco (Michael Nevitt, PhD – AG19069 ); and a Beeson Career Development Award (Neil Segal, MD – K23AG030945 ). The authors have no professional relationships with companies or manufacturers who will benefit from the results of the present study. An abstract of this data was presented at the 2008 annual meeting of the American College of Rheumatology.

PY - 2010/6

Y1 - 2010/6

N2 - Objective: Quadriceps weakness has been reported with incident but not progressive knee osteoarthritis (OA) in longitudinal studies. This study examined the relationship between quadriceps strength and worsening of knee joint space narrowing (JSN) over 30 months. Methods: Longitudinal, observational study of adults aged 50-79 years with OARSI JSN score <3 at baseline. Baseline measures included bilateral weight-bearing fixed flexion radiographs, isokinetic concentric quadriceps and hamstring strength, height and weight, and physical activity. Hamstring:quadriceps (H:Q) strength ratios also were evaluated. Worsening was defined as an increase in JSN score in the tibiofemoral and/or patellofemoral compartments on 30-month radiographs or total knee replacement. Knee-based analyses used generalized estimating equations, stratified by sex, to assess relationships between strength and knee JSN while controlling for covariance between knees within subjects as well as age, body mass index (BMI), history of knee injury and/or surgery, physical activity level and alignment. Results: 3856 knees (2254 females and 1602 males) with JSN score <3 at baseline and no missing follow-up data were included. Mean ± SD age was 62.2 ± 7.7 in women and 61.6 ± 8.1 in men. Women in the lowest tertile of quadriceps strength had an increased risk of whole knee JSN (OR=1.66, 95% CI =1.26, 2.19) and tibiofemoral JSN (OR=1.69, 95% CI=1.26, 2.28). However, no associations were found between strength and JSN in men or H:Q < 0.6 and JSN in men or women. Conclusions: In women but not in men, quadriceps weakness was associated with increased risk for tibiofemoral and whole knee JSN.

AB - Objective: Quadriceps weakness has been reported with incident but not progressive knee osteoarthritis (OA) in longitudinal studies. This study examined the relationship between quadriceps strength and worsening of knee joint space narrowing (JSN) over 30 months. Methods: Longitudinal, observational study of adults aged 50-79 years with OARSI JSN score <3 at baseline. Baseline measures included bilateral weight-bearing fixed flexion radiographs, isokinetic concentric quadriceps and hamstring strength, height and weight, and physical activity. Hamstring:quadriceps (H:Q) strength ratios also were evaluated. Worsening was defined as an increase in JSN score in the tibiofemoral and/or patellofemoral compartments on 30-month radiographs or total knee replacement. Knee-based analyses used generalized estimating equations, stratified by sex, to assess relationships between strength and knee JSN while controlling for covariance between knees within subjects as well as age, body mass index (BMI), history of knee injury and/or surgery, physical activity level and alignment. Results: 3856 knees (2254 females and 1602 males) with JSN score <3 at baseline and no missing follow-up data were included. Mean ± SD age was 62.2 ± 7.7 in women and 61.6 ± 8.1 in men. Women in the lowest tertile of quadriceps strength had an increased risk of whole knee JSN (OR=1.66, 95% CI =1.26, 2.19) and tibiofemoral JSN (OR=1.69, 95% CI=1.26, 2.28). However, no associations were found between strength and JSN in men or H:Q < 0.6 and JSN in men or women. Conclusions: In women but not in men, quadriceps weakness was associated with increased risk for tibiofemoral and whole knee JSN.

KW - Hamstring:quadriceps ratio

KW - Knee osteoarthritis

KW - Quadriceps muscle strength

KW - Rehabilitation

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Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort

Abstract

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