Asymmetries and relationships between dynamic loading, muscle strength, and proprioceptive acuity at the knees in symptomatic unilateral hip osteoarthritis.

Najia Shakoor,Kharma C Foucher,Joel A Block,Louis F Fogg,Rachel A Mikolaitis-Preuss,Markus A Wimmer

doi:10.1186/s13075-014-0455-7

Najia Shakoor, Kharma C Foucher + Show 4 more

Open Access

https://doi.org/10.1186/s13075-014-0455-7

Copy DOI

Abstract

IntroductionHigh joint loading, knee muscle weakness, and poor proprioceptive acuity are important factors that have been linked to knee osteoarthritis (OA). We previously reported that those with unilateral hip OA and bilateral asymptomatic knees are more predisposed to develop progressive OA in the contralateral knee relative to the ipsilateral knee. In the present study, we evaluate asymmetries in muscle strength and proprioception between the limbs and also evaluate relationships between these factors and joint loading that may be associated with the asymmetric evolution of OA in this group.MethodsSixty-two participants with symptomatic unilateral hip OA and asymptomatic knees were evaluated for muscle strength, joint position sense and dynamic joint loads at the knees. Muscle strength and proprioception were compared between limbs and correlations between these factors and dynamic joint loading were evaluated. Subgroup analyses were also performed in only those participants that fulfilled criteria for severe hip OA.ResultsQuadriceps muscle strength was 15% greater, and in the severe subgroup, proprioceptive acuity was 25% worse at the contralateral compared to ipsilateral knee of participants with unilateral hip OA (P <0.05). In addition, at the affected limb, there was an association between decreased proprioceptive acuity and higher knee loading (Spearman’s rho = 0.377, P = 0.007) and between decreased proprioceptive acuity and decreased muscle strength (Spearman’s rho = −0.328, P = 0.016).ConclusionsThis study demonstrated asymmetries in muscle strength and proprioception between the limbs in a unilateral hip OA population. Early alterations in these factors suggest their possible role in the future development of OA at the contralateral ‘OA-predisposed knee’ in this group. Furthermore, the significant association observed between proprioception, loading, and muscle strength at the affected hip limb suggests that these factors may be interrelated.

Highlights

High joint loading, knee muscle weakness, and poor proprioceptive acuity are important factors that have been linked to knee osteoarthritis (OA)
Gait data were available on 58 subjects, muscle strength data on 55 and proprioception data on 54 of the subjects
As we previously reported in this group, peak knee adduction moment (KAM) was approximately 10% higher at the contralateral knee compared to the ipsilateral knee (P = 0.029) [25]

Summary

Introduction

Knee muscle weakness, and poor proprioceptive acuity are important factors that have been linked to knee osteoarthritis (OA). We evaluate asymmetries in muscle strength and proprioception between the limbs and evaluate relationships between these factors and joint loading that may be associated with the asymmetric evolution of OA in this group. It is possible that muscle weakness itself contributes to aberrant dynamic joint loading and acts as a potential cause as well as the commonly assumed consequence of OA. This has not yet been demonstrated systematically and some investigations suggest that increased muscle strength could be detrimental in OA [17]. Understanding the role of muscle strength in OA is important since it is a modifiable factor in the disease

Objectives

Methods

Results

Discussion

Conclusion