University of Michigan, Ann Arbor, 48109, USA.
Am J Phys Med Rehabil. 2010 Jul;89(7):541-8. doi: 10.1097/PHM.0b013e3181ddd5c3.
Quadriceps weakness is a common clinical sign in persons with moderate-to-severe osteoarthritis and results in physical disability; however, minimal data exist to establish whether quadriceps weakness is present in early stages of the disease. Therefore, our purpose was to determine whether quadriceps weakness was present in persons with early radiographic and cartilaginous evidence of osteoarthritis. Further, we sought to determine whether quadriceps strength decreases as osteoarthritis severity increases.
Three hundred forty-eight women completed radiologic and magnetic resonance imaging evaluation, in addition to strength testing. Anterior-posterior radiographs were graded for tibiofemoral osteoarthritis severity using the Kellgren-Lawrence scale. Scans from magnetic resonance imaging were used to assess medial tibiofemoral and patellar cartilage based on a modification of the Noyes scale. The peak knee extension torque recorded was used to represent strength.
Quadriceps strength (Nm/kg) was 22% greater in women without radiographic osteoarthritis than in women with osteoarthritis (P < 0.05). Quadriceps strength was also greater in women with Noyes' medial tibial and femoral cartilage scores of 0 when compared in women with Noyes' grades 2 and 3-5 (P < or = 0.05).
Women with early evidence of osteoarthritis had less quadriceps strength than women without osteoarthritis as defined by imaging.
股四头肌无力是中重度骨关节炎患者的常见临床症状，可导致身体残疾；然而，目前仅有少量数据证实疾病早期是否存在股四头肌无力。因此，我们的目的是确定早期影像学和软骨骨关节炎证据的患者是否存在股四头肌无力。此外，我们还试图确定股四头肌力量是否随着骨关节炎严重程度的增加而下降。
348 名女性完成了放射学和磁共振成像评估以及力量测试。采用 Kellgren-Lawrence 量表对前后位 X 线片进行胫股关节炎严重程度分级。根据 Noyes 量表的改良版，对磁共振成像扫描进行内侧胫股和髌股软骨评估。记录的最大膝关节伸展扭矩用于代表力量。
无放射学骨关节炎的女性股四头肌力量（Nm/kg）比有骨关节炎的女性高 22%（P<0.05）。与 Noyes 分级 2 和 3-5 的女性相比，Noyes 内侧胫骨和股骨软骨评分 0 的女性股四头肌力量也更高（P<0.05）。
影像学定义为早期骨关节炎的女性股四头肌力量比无骨关节炎的女性低。
