Relationship of Hip Muscle Group Weakness to Deterioration of the OA Knee by MRI

描述（由申请人提供）：骨关节炎（OA），尤其是膝关节，是老年人慢性残疾的主要原因。目前很少有预防膝关节OA疾病进展或OA相关残疾的策略，这在很大程度上是由于对导致这些结果的因素的了解有限。近年来，流行病学研究已转向更侧重于进展，而不是膝关节OA的初始发展。此外，对局部因素的作用的认识也在增长，特别是那些改变关节载荷的因素。最近的研究结果支持髋部肌肉力量可能在膝关节炎患者的膝关节保护中起重要作用。在本应用中，我们建议检查膝关节OA患者的髋关节肌力，特别是髋关节外展肌和外旋肌，对软骨丢失和其他关节组织恶化的影响；身体机能下降；以及残疾进展。提出的目标以我们以前的结果为基础。该项目的长期目标是告知干预发展，利用髋关节肌肉使膝关节OA患者受益。我们建议对膝关节OA队列进行两项评估（基线和2年后），其中我们将测量髋关节肌肉的力量，并收集协变量、放射学、磁共振成像（MRI）、功能状态和残疾数据，使用最先进的方法评估每个结果。设备、脉冲序列和MRI协议的质量支持关节软骨的定量评估。这项研究的结果将为膝关节炎的物理和康复治疗的发展提供信息，这些治疗可能会利用髋关节肌肉组织。这是膝关节环境的一个关键、可改变的方面，在膝关节OA中很少受到关注，尽管髋关节肌肉在膝关节水平和个人水平的功能中都有潜在的重要作用。拟议的研究将包括MRI和x射线的结构结果，以及自我报告和任务表现的个人相关结果。鉴于髋关节所起的作用，髋关节肌肉状态不仅与膝关节OA进展有关，而且与相关的功能限制和残疾有关。膝关节骨关节炎（OA）是导致残疾的主要原因。目前很少有预防OA疾病进展或OA相关残疾的策略。我们建议检查膝关节OA患者的髋关节肌力，特别是髋关节外展肌和外旋肌，对软骨丢失和其他关节组织恶化、身体功能下降和残疾进展的影响。拟议研究的结果将为利用髋关节肌肉组织的膝关节OA治疗提供信息。

DESCRIPTION (provided by applicant): Osteoarthritis (OA), especially at the knee, is a leading cause of chronic disability in the elderly. Few strategies to prevent knee OA disease progression or OA-related disability exist, in large part due to limited knowledge of factors responsible for these outcomes. In recent years, there has been a shift in epidemiological studies towards heavier focus on progression than on the initial development of knee OA. Also, recognition of the role in progression of local factors is growing, especially those factors that modify joint loading. Recent findings support that hip muscle forces may play an important role in knee joint protection in persons with osteoarthritic knees. In this application, we propose to examine, in persons with knee OA, the effect of hip muscle strength, particularly hip abductor and external rotator, on: cartilage loss and worsening of other joint tissues; physical function decline; and disability progression. The proposed aims build upon our previous results. A long-term goal of the proposed project is to inform intervention development that capitalizes upon the hip muscles to benefit persons with knee OA. We propose two evaluations (at baseline and 2 years later) of a cohort with knee OA, in which we will measure strength of hip muscles as well as collect covariate, radiographic, magnetic resonance imaging (MRI), functional status, and disability data, using state-of-the-art approaches to assess each outcome. The equipment, pulse sequences, and quality of the MRI protocol support quantitative assessment of articular cartilage. The results of this study will inform development of physical and rehabilitative therapy for knee OA that might take advantage of the hip musculature. This is a key, modifiable aspect of the knee joint environment that has received little attention in knee OA, despite a potentially large role of hip muscles in both knee-level and person-level function. The proposed study will include structural outcomes by MRI and by x-ray and person-relevant outcomes by self-report and task performance. Given the role played by the hip, it is plausible that hip muscle status will be linked not only to knee OA progression but also to associated function limitation and disability. Osteoarthritis (OA) at the knee is a major cause of disability. Few strategies to prevent OA disease progression or OA-related disability exist. We propose to examine in persons with knee OA the effect of hip muscle strength, particularly hip abductor and external rotator, on cartilage loss and worsening of other joint tissues, physical function decline, and disability progression. The results of the proposed study will inform therapy of knee OA that takes advantage of the hip musculature.