Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis.
Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis.
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DOI：
10.1002/art.24182
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发表时间：
2009-01
影响因子：
--
通讯作者：
Felson, David T.
中科院分区：
文献类型：
--
作者：
Amin, Shreyasee;Baker, Kristin;Niu, Jingbo;Clancy, Margaret;Goggins, Joyce;Guermazi, Ali;Grigoryan, Mikayel;Hunter, David J.;Felson, David T.
确定膝关节骨性关节炎（OA）患者股四头肌力量对胫股关节和髌股关节软骨丢失的影响（通过磁共振成像[MRI]评估）以及对膝关节疼痛和功能的影响。我们研究了265名受试者（154名男性和111名女性，平均±SD年龄67±9岁），他们符合美国风湿病学会对症状性膝关节炎的标准，并参加了一项为期30个月的前瞻性膝关节炎自然史研究。在同心膝关节伸展时，在基线等速测量股四头肌力量。在基线、15个月和30个月时对膝关节进行MRI检查，评估胫股关节和髌股关节的软骨损失，并分别评估内侧和外侧关节室。在基线和随访时，使用视觉模拟量表评估膝关节疼痛，使用西安大略和麦克马斯特大学骨关节炎指数评估身体功能。股四头肌强度与胫股关节软骨损失之间没有关联。不正膝的结果相似。然而，更大的股四头肌力量可以防止髌股关节外侧腔室的软骨损失（对于力量的最高和最低位数，优势比为0.4[95%置信区间0.2,0.9]）。在随访中，股四头肌力量大的患者膝盖疼痛更少，身体功能更好（P < 0.001）。更大的股四头肌力量对胫股关节的软骨损失没有影响，包括不对齐的膝关节。我们首次报道，更大的股四头肌力量可以防止髌股关节外侧腔室的软骨损失，这一发现需要证实。在随访期间，股四头肌力量更大的受试者膝盖疼痛更少，身体功能更好。
To determine the effect of quadriceps strength in individuals with knee osteoarthritis (OA) on loss of cartilage at the tibiofemoral and patellofemoral joints (assessed by magnetic resonance imaging [MRI]) and on knee pain and function. We studied 265 subjects (154 men and 111 women, mean ± SD age 67 ± 9 years) who met the American College of Rheumatology criteria for symptomatic knee OA and who were participating in a prospective, 30-month natural history study of knee OA. Quadriceps strength was measured at baseline, isokinetically, during concentric knee extension. MRI of the knee at baseline and at 15 and 30 months was used to assess cartilage loss at the tibiofemoral and patellofemoral joints, with medial and lateral compartments assessed separately. At baseline and at followup visits, knee pain was assessed using a visual analog scale, and physical function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index. There was no association between quadriceps strength and cartilage loss at the tibiofemoral joint. Results were similar in malaligned knees. However, greater quadriceps strength was protective against cartilage loss at the lateral compartment of the patellofemoral joint (for highest versus lowest tertile of strength, odds ratio 0.4 [95% confidence interval 0.2, 0.9]). Those with greater quadriceps strength had less knee pain and better physical function over followup (P < 0.001). Greater quadriceps strength had no influence on cartilage loss at the tibiofemoral joint, including in malaligned knees. We report for the first time that greater quadriceps strength protected against cartilage loss at the lateral compartment of the patellofemoral joint, a finding that requires confirmation. Subjects with greater quadriceps strength also had less knee pain and better physical function over followup.
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影响因子：
--
作者：
Baker, KR;Xu, L;Felson, D
通讯作者：
Felson, D
影响因子：
27.4
作者：
Amin, S.;Niu, J.;Felson, D. T.
通讯作者：
Felson, D. T.
影响因子：
39.2
作者：
Felson, DT;Chaisson, CE;Gale, DR
通讯作者：
Gale, DR
影响因子：
120.7
作者：
Ettinger, WH;Burns, R;Craven, T
通讯作者：
Craven, T
影响因子：
2.8
作者：
Lewek, MD;Rudolph, KS;Snyder-Mackler, L
通讯作者：
Snyder-Mackler, L