Abstract

It is not clear whether the strength or endurance of thigh muscles (quadriceps and hamstring) is positively or negatively correlated with the adduction moment of osteoarthritic knees. This study therefore assessed the relationships between the strength and endurance of the quadriceps and hamstring muscles and adduction moment in osteoarthritic knees and evaluated predictors of the adduction moment. The study cohort comprised 35 patients with unilateral medial osteoarthritis and varus deformity who were candidates for open wedge osteotomy. The maximal torque (60°/sec) and total work (180°/sec) of the quadriceps and hamstring muscles and knee adduction moment were evaluated using an isokinetic testing device and gait analysis system. The total work of the quadriceps (r = 0.429, P = 0.037) and hamstring (r = 0.426, P = 0.045) muscles at 180°/sec each correlated with knee adduction moment. Preoperative varus deformity was positively correlated with adduction moment (r = 0.421, P = 0.041). Multiple linear regression analysis showed that quadriceps endurance at 180°/sec was the only factor independently associated with adduction moment (β = 0.790, P = 0.032). The adduction moment of osteoarthritic knees correlated with the endurance, but not the strength, of the quadriceps muscle. However, knee adduction moment did not correlate with the strength or endurance of the hamstring muscle.

Highlights

  • Biomechanical factors are believed to play a role in the progression of knee osteoarthritis.[1]

  • The effects of biomechanical factors on the progression of knee osteoarthritis may best be evaluated by measuring the dynamic load on the knee joint during walking,[2, 3] because mechanical overload of the joint has detrimental effects on the progression of knee osteoarthritis.[4, 5]

  • Our findings suggest that the total work of muscles at 180°/sec should be included in isokinetic tests of muscles around the knee joint, especially when evaluating the association between thigh muscles and knee adduction moment

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Summary

Introduction

Biomechanical factors are believed to play a role in the progression of knee osteoarthritis.[1]. The knee adduction moment is considered a surrogate measure of dynamic loading on the knee joint and is thought to increase as osteoarthritis becomes more severe.[6, 7]. The adduction moment may show a positive correlation with quadriceps strength, because the quadriceps is the major abduction moment generator that stabilizes the loaded knee joint.[12, 13] it remains unclear whether quadriceps strength and endurance are positively or negatively correlated with adduction moment in osteoarthritic knees. It was hypothesized that quadriceps strength and endurance are negatively correlated with knee adduction moment in osteoarthritic knees

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