Knee Power Is an Important Parameter in Understanding Medial Knee Joint Load in Knee Osteoarthritis

Calder, Kristina M.; Acker, Stacey M.; Arora, Neha; Beattie, Karen A.; Callaghan, Jack P.; Adachi, Jonathan D.; Maly, Monica R.

doi:10.1002/acr.22223

Cited by 16 publications

(14 citation statements)

References 48 publications

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“…That study also showed that knee adduction moment was not related to knee extensor strength, but was related to knee extensor power. [ 27 ]Although no correlation was observed between knee extensor strength and adduction moment in the present study, a close correlation was found between quadriceps endurance and knee adduction moment. Direct comparison of the results of the two earlier studies mentioned above with those of the present work is made difficult by the different measurement variables, such as isokinetic strength, power, and endurance, used in the studies.…”

Section: Discussioncontrasting

confidence: 64%

“…Agreeing with our results, recent studies also found no correlation between knee extensor strength and knee adductor moment. [ 27 , 28 ]A previous study assessed the relationship between quadriceps strength and knee adduction moment in patients with osteoarthritis. That study, which measured quadriceps strength and peak knee adduction moment during walking in 184 subjects with medial knee osteoarthritis, found no significant association between quadriceps strength and peak knee adduction moment.…”

Section: Discussionmentioning

confidence: 99%

“…However, that study did not evaluate the foot progression angle, which also affects the knee adduction moment. The second study mentioned above[ 27 ] and our study did not measure the walking speed, foot progression angle, and magnitude of knee pain. Therefore, direct comparison of the results of these studies is difficult.…”

Section: Discussionmentioning

confidence: 99%

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Correlation between Quadriceps Endurance and Adduction Moment in Medial Knee Osteoarthritis

Lee

Ahn

et al. 2015

PLoS ONE

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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.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

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Correlation between Quadriceps Endurance and Adduction Moment in Medial Knee Osteoarthritis

Lee

Ahn

et al. 2015

PLoS ONE

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“…Similarly, in 40 participants with established knee OA, knee extension muscle power, measured isotonically using a dynamometer at low external resistances, was more predictive of WOMAC-assessed function than peak isometric muscle strength (17). Isotonic knee extensor muscle power was also superior to muscle strength in determining medial knee loading and adduction moments during kinematic gait trials in 53 patients with clinical knee OA (18). In the current study, we incorporated a dynamic, well-validated assessment of leg extensor muscle power within a large population of subjects with knee OA, and demonstrated the novel clinical importance of muscle power as an independent predictor of pain and quality of life in these symptomatic patients.…”

mentioning

confidence: 93%

“…(12, 15, 16) Two small studies in knee OA patients have demonstrated that lower extremity power is more predictive of self-reported function than strength,(17) and muscle power is superior than strength in determining medial knee loading and adduction moments. (18) However, no study to date has comprehensively investigated lower extremity muscle power as a potential determinant of disease severity in knee OA or evaluated specific relationships between muscle power, knee pain and quality of life among individuals with symptomatic knee OA.…”

mentioning

confidence: 99%

Muscle Power Is an Independent Determinant of Pain and Quality of Life in Knee Osteoarthritis

Reid

Price

Harvey

et al. 2015

Arthritis & Rheumatology

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Objectives We examined the relationships between lower extremity muscle strength, power and perceived disease severity in participants with knee osteoarthritis (OA). We hypothesized that dynamic leg extensor muscle power would be associated with pain and quality of life in knee OA. Methods We used baseline data from a randomized controlled trial in 190 participants with knee OA (age: 60.2 ± 10.4 yrs; BMI: 32.7 ± 7.2 kg/m2). Knee pain was measured using the Western Ontario and McMaster Osteoarthritis Index and health-related quality of life using the Short Form 36 (SF-36). One-repetition maximum (1RM) strength was assessed using the bilateral leg press and peak muscle power was measured during 5 maximum voluntary velocity repetitions at 40% and 70% of 1RM. Results In univariate analysis, greater muscle power was significantly associated with pain (r = -0.17, P < 0.02). It was also significantly and positively associated with SF-36 physical component scores (PCS) (r = 0.16, P < 0.05). After adjusting for multiple covariates, muscle power was a significant independent predictor of pain (P ≤ 0.05) and PCS (P ≤ 0.04). However, strength was not an independent determinant of pain or quality of life (P ≥ 0.06). Conclusions Muscle power is an independent determinant of pain and quality of life in knee OA. Compared to strength, muscle power may be a more clinically important measure of muscle function within this population. New trials to systematically examine the impact of muscle power training interventions on disease severity in knee OA are particularly warranted.

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Relationship Between Knee Biomechanics and Pain in People With Knee Osteoarthritis: A Systematic Review and Meta‐Analysis

Hutchison

Grayson

Hiller

et al. 2022

Arthritis Care & Research

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Objective Our primary aim was to determine the cross‐sectional relationship between knee biomechanics during gait and pain in people with medial knee osteoarthritis. Our secondary aim was to evaluate differences in knee biomechanics between symptomatic and asymptomatic participants with medial knee osteoarthritis. Methods Four online databases were searched from inception to July 2021. Eligible studies included people with medial/nonspecific knee osteoarthritis and a reported relationship between knee biomechanics during gait and pain or biomechanics of symptomatic and asymptomatic participants. Two reviewers independently extracted data and evaluated risk of bias. Random‐effects meta‐analyses were performed when three or more studies reported the same biomechanical variable for pooling (knee adduction moment [KAM], KAM impulse, varus thrust, and peak knee flexion moment [KFM]). Results Forty studies were included. Methodological quality ranged from 4 to 9/10. Forty‐seven unique biomechanical variables were reported. For the KAM, there was no correlation with pain for peak values pooled (early stance and overall) (r = 0.00, 95% confidence interval [95% CI]: −0.12, 0.11, k = 16), a small negative correlation for early stance peak alone (r = −0.09, 95% CI −0.18, −0.002, k = 12), and a medium positive correlation for the overall peak during stance (r = 0.30, 95% CI 0.17, 0.42, k = 4). Metaregression identified that body mass index moderated the peak KAM–pain relationship (P < 0.001). KAM impulse had a small positive correlation with pain (r = 0.23, 95% CI 0.04, 0.40, k = 5), and people with varus thrust had 3.84 greater odds of reporting pain compared with people without (95% CI 1.72, 8.53, k = 3). Meta‐analyses for the peak KFM and pain correlation and secondary aim were nonsignificant. Conclusion Some knee gait biomechanics were associated with pain in this cohort. Longitudinal studies are required to determine causality.

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Knee Power Is an Important Parameter in Understanding Medial Knee Joint Load in Knee Osteoarthritis

Cited by 16 publications

References 48 publications

Correlation between Quadriceps Endurance and Adduction Moment in Medial Knee Osteoarthritis

Correlation between Quadriceps Endurance and Adduction Moment in Medial Knee Osteoarthritis

Muscle Power Is an Independent Determinant of Pain and Quality of Life in Knee Osteoarthritis

Relationship Between Knee Biomechanics and Pain in People With Knee Osteoarthritis: A Systematic Review and Meta‐Analysis

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