Quadriceps femoris muscle function prior and after total knee arthroplasty in women with knee osteoarthritis

Abstract

Prospective comparative study, Level II.

Muscle Function during Selected Weight-Bearing Activities in Adults with Knee Osteoarthritis- A Narrative Overview

“…This is surprising given that subjects with knee osteoarthritis do present with significant muscle impairments that affect physical function [54] as well as wide variations in whole muscle contractile kinetics [55] . Rate of force development [13] , and effusion, a determinant of muscle function in knee osteoarthritis, is also not well correlated with findings in the context of the present topic [45] . Hence, although muscle strength is often a target of therapy for knee osteoarthritis, there is no direct information from current studies that this approach will be universally desirable or effective.…”

“…To this end more stringent research designs with clear inclusion and exclusion criteria are desirable to tease out possible pathogenic or confounding factors in gait and electromyographic studies such as disease stage [35,44] , the presence of instability [44] , effusion [45] , proprioception abnormalities [47] , excess body weight [76,77] fatigue [78] , instability [79] , stiffness [80] , inflammatory cytokines [81] , gamma-loop dysfunction [82] , or related muscle forces at the knee during gait [83] . Whether rate of force development, muscle endurance and/or muscle power, muscle imbalance, muscle force steadiness or neuromuscular efficiency are more profound functional determinants than strength [13,31,41,80,[84][85][86] should also be examined. Which interventions produce the best functional outcomes and why should be examined as well to better understand the muscular mechanisms underpinning functional weightbearing activities in patients with varying degrees of knee joint osteoarthritis.…”

“…For example, abnormal physical stresses can arguably be placed on the joint as a result of reactive muscle inhibition consequent to injury [4] , muscle weakness, uncoordinated muscular forces [4,5] excessive muscular forces [6][7][8] , muscle atrophy, contractile dysfunction [9] , or all of these in combination [10][11][12] . Moreover, in addition to one or more joints being adversely affected by a variety of reactive structural and functional abnormalities, muscles alone can arguably influence the onset of the condition, as well as outcomes of attempts to treat osteoarthritis significantly and negatively if they fail to absorb joint loads in a timely and optimal manner [12,13] . Since improvements in the prevention and treatment of osteoarthritis depend on a clear understanding of its etiology, this review specifically sought to examine the extent to which the role of muscle dysfunction, potentially amenable to detection, classification, and intervention, has been examined in the context of knee joint osteoarthritis.…”

Moderate varus/valgus malalignment after total knee arthroplasty has little effect on knee function or muscle strength

“…Similar findings were reported by Berth et al (2002) and Yoshida et al (2008), who investigated muscle strength from 1 to 3 years after TKA and observed an increase relative to preoperative values. However, Vahtrik et al (2012), who investigated muscle strength at 3 and 6 months after TKA, found that postoperative muscle strength was lower than the preoperative value. Thus, it may be that after TKA surgery, the recovery and improvement of muscle strength can take more than 6 months.…”

“…However, full recovery of muscle strength after TKA is uncommon (Berth et al 2002, Valtonen et al 2009, Maffiuletti et al 2010, Vahtrik et al 2012). …”