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

描述(申请人提供)：骨关节炎(OA)，特别是在膝盖，是导致老年人慢性残疾的主要原因。预防膝骨性关节炎疾病进展或膝骨性关节炎相关残疾的策略很少，这在很大程度上是由于对导致这些结果的因素了解有限。近年来，流行病学研究已经转向更多地关注进展，而不是最初的膝骨性关节炎的发展。此外，对局部因素在进展中的作用的认识也在增长，特别是那些改变关节负荷的因素。最近的发现支持，髋部肌肉力量可能在膝骨性关节炎患者的膝关节保护中发挥重要作用。在这项应用中，我们建议研究膝骨性关节炎患者的髋部肌肉力量，特别是髋外展肌和外旋肌力量对以下方面的影响：软骨丢失和其他关节组织的恶化；身体功能下降；以及残疾进展。拟议的目标是在我们之前的成果基础上提出的。拟议项目的一个长期目标是通知干预发展，使髋部肌肉受益于膝盖骨关节炎患者。我们建议对膝骨性关节炎队列进行两次评估(基线和两年后)，其中我们将测量髋部肌肉的强度，并收集协变量、X线片、磁共振成像(MRI)、功能状态和残疾数据，使用最先进的方法来评估每一种结果。MRI的设备、脉冲序列和质量支持关节软骨的定量评估。这项研究的结果将为膝骨性关节炎的物理和康复治疗的发展提供信息，可能利用髋部肌肉系统的优势。这是膝关节环境的一个关键的、可改变的方面，在膝骨性关节炎中很少受到关注，尽管髋部肌肉在膝关节水平和人的水平功能中都有潜在的重要作用。拟议的研究将包括核磁共振和X光的结构性结果，以及自我报告和任务绩效的与人相关的结果。考虑到髋关节所起的作用，髋部肌肉状况不仅与膝关节骨关节炎的进展有关，而且还与相关的功能限制和残疾有关，这是合理的。膝关节骨关节炎(OA)是致残的主要原因。几乎没有预防骨性关节炎疾病进展或骨性关节炎相关残疾的策略。我们建议研究膝关节骨性关节炎患者的髋部肌肉力量，特别是髋外展肌和外旋肌力量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。这项拟议的研究结果将为利用髋关节肌肉系统治疗膝骨性关节炎提供参考。

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.