Neuromuscular quadriceps dysfunction prior to osteoarthritis of the knee

Abstract

Decreased maximal quadriceps strength and voluntary activation has been observed in patients with osteoarthritis in previous studies, but those results d o not allow any conclusions to be drawn as to whether quadriceps dysfunction precedes or follows osteoarthritis. Thirty-two patients (group a) who underwent partial ineniscectomy 48 k 9 month prior to the study were matched according to their weight and body mass index with a control group (group b). The twitch interpolation technique was used to determine maximal voluntary contraction (MVC) and voluntary activation (VA) of the quadriceps muscle of both legs. Subjective assessment of the knee was performed using the Lysholni-Score. AP and lateral X-rays of the operated knee were obtained. None of the participants showed any evidence of characteristic radiological or clinical signs for osteoarthritis. A significantly lower MVC was noticed in both the affected and the contralateral knee of group a in comparison to group b (p < 0.01). The VA in group a yielded 80.9i 15.4% for the injured side and 83.1 f 11.5% for the contralateral side, with no statistical difference (p = 0.18). The VA in group b was 89.4 i 5.8% for the right side and 88 ? 6.8% for the left side both being significantly higher in comparison to group a.This study has shown, that patients following meniscus resection present with bilateral quadriceps weakness as already described in patients with manifest osteoarthritis. The authors hypothesise that muscle dysfunction may be an etiologic factor underlying the pathologic changes of osteoarthritis. Whether muscle dysfunction occurs also at other sites, e.g. in the upper extremity, remains unclear but would be of interest in order to detect a generalized neuromuscular dysfunction.

Lower leg muscle atrophy in ankle osteoarthritis

“…Each wavelet was represented by a bell shaped filter curve in frequency space and had a short wave as a counterpart in time space. The wavelets were characterized by their center frequency (Hz), bandwidth (Hz), and time resolution (ms): wavelet 0 (7 Hz, 15 ). An interpolation was used to convert noninteger wavelet numbers (e.g., mean wavelet number) to frequencies.…”

“…6,8,[15][16][17][18][19][20][21] It has been shown that in knee OA the quadriceps strength is usually reduced by 14% to 45% compared to control subjects. 6,8,18,19,21 Sirca et al 22 reported that degenerative hip OA was associated with an atrophy of type II fibers.…”

Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis

“…5 In addition to the effects on the joint structure and function, OA also has a negative effect on the musculoskeletal system. Patients with knee OA have decreased knee extensor strength compared to healthy subjects [6][7][8][9][10] and compared to the healthy contralateral limb. 11,12 Evidence also suggests that the muscle weakness is associated with a decrease in muscle mass.…”

Quadriceps and hamstrings muscle control in athletic males and females

“…4 Altered biomechanics and neuromuscular control have been postulated to play a significant role in the disproportionate incidence of knee joint injuries and osteoarthritis observed in females. 5,6 Consequently, researchers have recently placed significant effort into elucidating neuromuscular and biomechanical differences in males and females. Although researchers have evaluated gender differences in muscle responses to destabilizing loads applied to the joint and knee kinematics and kinetics during sport specific activities, [7][8][9][10][11] it remains unclear whether there are fundamental differences in the voluntary knee muscle control strategies used by athletic males and females.…”