Quadriceps weakness and its relationship to tibiofemoral and patellofemoral knee osteoarthritis in Chinese - The Beijing Osteoarthritis Study
Quadriceps weakness and its relationship to tibiofemoral and patellofemoral knee osteoarthritis in Chinese - The Beijing Osteoarthritis Study
复制标题
DOI：
10.1002/art.20261
复制
发表时间：
2004-06-01
影响因子：
--
通讯作者：
Felson, D
中科院分区：
文献类型：
--
作者：
Baker, KR;Xu, L;Felson, D
Objective.据报道，虚弱是胫股膝关节骨关节炎（OA）的一个特征，当髌骨股关节未接合时，脚跟撞击时的脉冲载荷期间的减震可能会导致该间室疾病。我们的目的是确定肌无力与特定间隔的膝关节OA的关联，以评估这种关系的性别特异性差异，并确定，通过评估无症状的个人与OA，症状是否可能产生的弱点看到OA。这项横断面研究涉及来自中国北京4个中心区的2，472名受试者（1，475名女性和997名男性），年龄≥ 60岁。对于所有受试者，在负重期间获得每个膝关节的天际线视图和两个膝关节的前后位（AP）或后前位（PA）X线片。X线片由一名阅片人读取Kellgren/Lawrence（K/L）分级、关节间隙狭窄（JSN）和骨赘。当AP/PA视图上的K/L等级大于或等于2时，我们将受试者定义为胫股OA;当Skyline视图上的骨赘评分大于或等于2时（或当JSN评分大于或等于2且骨赘评分大于或等于1时），我们将受试者定义为髌股OA;当膝关节X线片上同时存在髌股和胫股OA时，我们将受试者定义为混合OA。分别测量每条腿的力量，并通过膝关节疼痛评估。在女性中，股四头肌无力与胫股OA（比值比[OR] 0.7，95%置信区间[95% CI] 0.4-1.0）、髌股OA（OR 0.6，95% CI 0.4-0.9）和混合OA（OR 0.4，95% CI 0.3-0.6）相关。在男性中，无力与混合型OA相关（OR 0.5，95% CI 0.3-0.8），提示髌股OA与无力相关的OR与女性相同，尽管在男性中，该趋势未达到统计学显著性（P = 0.12）。在男性中，孤立性胫股疾病与虚弱无关;然而，本分析的样本量有限。当排除膝关节症状的受试者时，股四头肌无力与OA的关系减弱，只有肌无力与混合型OA之间的关系仍有意义。股四头肌无力和膝关节OA在所有间室中存在相关性，在混合性疾病中相关性最强。疼痛可能会导致这种弱点。
Objective. Weakness has been documented as a feature of tibiofemoral knee osteoarthritis (OA) and may cause disease in this compartment by shock absorption during impulse loading at heel strike, when the patellofemoral joint is not engaged. Our objective was to determine the association of muscle weakness with compartment-specific knee OA, to evaluate sex-specific differences in this relationship, and to determine, by evaluating asymptomatic individuals with OA, whether symptoms may produce the weakness seen in OA.Methods. This cross-sectional study involved 2,472 subjects (1,475 women and 997 men) ages 60 years or older from 4 central districts of Beijing, China. For all subjects, a skyline view of each knee and an anteroposterior (AP) or posteroanterior (PA) radiograph of both knees were obtained during weight bearing. Radiographs were read by one reader for Kellgren/Lawrence (K/L) grade, joint space narrowing (JSN), and osteophytes. We defined a subject as having tibiofemoral OA when the K/L grade was greater than or equal to2 on AP/PA view, patellofemoral OA on skyline view when the osteophyte score was greater than or equal to2 (or when the JSN score was greater than or equal to2 and the osteophyte score was greater than or equal to1), and mixed OA when the knee had both patellofemoral and tibiofemoral radiographic OA. Strength was measured isometrically for each leg separately, and knee pain was evaluated by questionnaire.Results. In women, quadriceps weakness was associated with tibiofemoral OA (odds ratio [OR] 0.7, 95% confidence interval [95% CI] 0.4-1.0), patellofemoral OA (OR 0.6, 95% CI 0.4-0.9), and mixed OA (OR 0.4, 95% CI 0.3-0.6). In men, weakness was associated with mixed OA (OR 0.5, 95% CI 0.3-0.8), and the ORs suggesting an association of patellofemoral OA with weakness were the same as those in women, although in men this trend did not reach statistical significance (P = 0.12). In men, isolated tibiofemoral disease was not associated with weakness; however, the sample size in this analysis was limited. When subjects with knee symptoms were excluded, the relationship of quadriceps weakness to OA was attenuated, with only the relationship between muscle weakness and mixed OA remaining significant.Conclusion. There is a relationship between quadriceps weakness and knee OA in all compartments, with the strongest association in mixed disease. Pain may contribute to some of this weakness.