Document Detail


Quadriceps weakness and osteoarthritis of the knee.
MedLine Citation:
PMID:  9230035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The quadriceps weakness commonly associated with osteoarthritis of the knee is widely believed to result from disuse atrophy secondary to pain in the involved joint. However, quadriceps weakness may be an etiologic factor in the development of osteoarthritis. OBJECTIVE: To explore the relation between lower-extremity weakness and osteoarthritis of the knee. DESIGN: Cross-sectional prevalence study. SETTING: Population-based, with recruitment by random-digit dialing. PARTICIPANTS: 462 volunteers 65 years of age or older. MEASUREMENTS: Radiographs of the knee were graded for the presence of osteoarthritis. Knee pain and function were assessed with the Western Ontario and McMaster Universities Arthritis Index, the strength of leg flexors and extensors was assessed with isokinetic dynamometry, and lower-extremity lean tissue mass was assessed with dual-energy x-ray absorptiometry. RESULTS: Among participants with osteoarthritis, quadriceps weakness, but not hamstring weakness, was common. The ratio of extensor strength to body weight was approximately 20% lower in those with than in those without radiographic osteoarthritis. Notably, among women with tibiofemoral osteoarthritis, extensor weakness was present in the absence of knee pain and was seen in participants with normal lower-extremity lean mass (extensor strength, 30.1 lb-ft for those with osteoarthritis and 34.8 lb-ft for those without osteoarthritis; P < 0.001). After adjustment for body weight, age, and sex, lesser quadriceps strength remained predictive of both radiographic and symptomatic osteoarthritis of the knee (odds ratio for prevalence of osteoarthritis per 10 lb-ft loss of strength, 0.8 [95% CI, 0.71 to 0.90] for radiographic osteoarthritis and 0.71 [CI, 0.51 to 0.87] for symptomatic osteoarthritis). CONCLUSION: Quadriceps weakness may be present in patients who have osteoarthritis but do not have knee pain or muscle atrophy; this suggests that the weakness may be due to muscle dysfunction. The data are consistent with the possibility that quadriceps weakness is a primary risk factor for knee pain, disability, and progression of joint damage in persons with osteoarthritis of the knee.
Authors:
C Slemenda; K D Brandt; D K Heilman; S Mazzuca; E M Braunstein; B P Katz; F D Wolinsky
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of internal medicine     Volume:  127     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-07-22     Completed Date:  1997-07-22     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  97-104     Citation Subset:  AIM; IM    
Affiliation:
Indiana University School of Medicine, Indianapolis, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Body Weight
Cross-Sectional Studies
Female
Humans
Knee Joint* / radiography
Leg* / physiopathology
Male
Muscle Weakness / epidemiology,  etiology*,  physiopathology
Muscle, Skeletal / physiopathology
Odds Ratio
Osteoarthritis / complications*,  drug therapy,  radiography
Pain / etiology
Prevalence
Grant Support
ID/Acronym/Agency:
2P60AR20582-20/AR/NIAMS NIH HHS; M01 RR00750/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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