Shakoor Najia, Foucher Kharma C, Wimmer Markus A, Mikolaitis-Preuss Rachel A, Fogg Louis F, Block Joel A
Arthritis Res Ther. 2014 Dec 14;16(6):455. doi: 10.1186/s13075-014-0455-7.
High joint loading, knee muscle weakness, and poor proprioceptive acuity are important factors that have been linked to knee osteoarthritis (OA). We previously reported that those with unilateral hip OA and bilateral asymptomatic knees are more predisposed to develop progressive OA in the contralateral knee relative to the ipsilateral knee. In the present study, we evaluate asymmetries in muscle strength and proprioception between the limbs and also evaluate relationships between these factors and joint loading that may be associated with the asymmetric evolution of OA in this group.
Sixty-two participants with symptomatic unilateral hip OA and asymptomatic knees were evaluated for muscle strength, joint position sense and dynamic joint loads at the knees. Muscle strength and proprioception were compared between limbs and correlations between these factors and dynamic joint loading were evaluated. Subgroup analyses were also performed in only those participants that fulfilled criteria for severe hip OA.
Quadriceps muscle strength was 15% greater, and in the severe subgroup, proprioceptive acuity was 25% worse at the contralateral compared to ipsilateral knee of participants with unilateral hip OA (P <0.05). In addition, at the affected limb, there was an association between decreased proprioceptive acuity and higher knee loading (Spearman's rho = 0.377, P = 0.007) and between decreased proprioceptive acuity and decreased muscle strength (Spearman's rho = -0.328, P = 0.016).
This study demonstrated asymmetries in muscle strength and proprioception between the limbs in a unilateral hip OA population. Early alterations in these factors suggest their possible role in the future development of OA at the contralateral 'OA-predisposed knee' in this group. Furthermore, the significant association observed between proprioception, loading, and muscle strength at the affected hip limb suggests that these factors may be interrelated.
高关节负荷、膝关节肌肉无力和本体感觉敏锐度差是与膝关节骨关节炎（OA）相关的重要因素。我们之前报道过，单侧髋关节OA且双侧膝关节无症状的患者，相对于同侧膝关节，对侧膝关节更易发展为进行性OA。在本研究中，我们评估了双下肢之间肌肉力量和本体感觉的不对称性，并评估了这些因素与关节负荷之间的关系，这些关系可能与该组OA的不对称演变有关。
对62名有症状的单侧髋关节OA且膝关节无症状的参与者进行了膝关节肌肉力量、关节位置觉和动态关节负荷评估。比较了双下肢之间的肌肉力量和本体感觉，并评估了这些因素与动态关节负荷之间的相关性。还仅对符合重度髋关节OA标准的参与者进行了亚组分析。
单侧髋关节OA患者对侧膝关节的股四头肌力量比同侧膝关节大15%，在重度亚组中，对侧膝关节的本体感觉敏锐度比同侧膝关节差25%（P<0.05）。此外，在患侧肢体，本体感觉敏锐度降低与较高的膝关节负荷之间存在关联（斯皮尔曼相关系数rho = 0.377，P = 0.007），本体感觉敏锐度降低与肌肉力量降低之间也存在关联（斯皮尔曼相关系数rho = -0.328，P = 0.016）。
本研究表明单侧髋关节OA人群双下肢之间存在肌肉力量和本体感觉的不对称性。这些因素的早期改变表明它们可能在该组对侧“易患OA的膝关节”未来OA发展中发挥作用。此外，在患侧髋关节肢体观察到的本体感觉、负荷和肌肉力量之间的显著关联表明这些因素可能相互关联。
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