Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental Sciences, 1-754 Asahimachidori Cuo-ku, Niigata City, Niigata, 951-8510, Japan.
Division of Health and Sports, Niigata University of Health and Welfare, Niigata City, Japan.
Knee Surg Sports Traumatol Arthrosc. 2018 Sep;26(9):2607-2614. doi: 10.1007/s00167-017-4551-5. Epub 2017 Apr 26.
The purpose of this study was to investigate the causal relationship between quadriceps muscle strength and radiographic knee osteoarthritis (OA) in a longitudinal study.
The present study included 976 knees from 488 subjects who participated in both the 5th (2007) and 7th (2013) surveys of the Matsudai Knee Osteoarthritis Survey. Bilateral quadriceps strengths of each subject were measured using the quadriceps training machine (QTM-05F, Alcare Co., Ltd., Tokyo, Japan). Additionally, weight-bearing standing knee radiographs were obtained, and knee OA was graded according to the Kellgren-Lawrence classification system. The relationships between quadriceps strength and the incidence and progression of radiographic knee OA were assessed using multiple logistic regression analysis.
After adjusting for age and body mass index (BMI), both female and male knees in the lowest quantile of quadriceps strength had higher risk of the incidence of radiographic knee OA compared with the highest quantile of quadriceps strength (women: OR 2.414, 95% CI 1.098-5.311; men: OR 2.774, 95% CI 1.053-7.309). In contrast, after adjusting for age, BMI and femorotibial angle, both female and male knees in the lowest quantile compared with the highest quantile of quadriceps strength did not differ in risk of the progression of radiographic knee OA (women: OR 1.040, 95% CI 0.386-2.802; men: OR 2.814, 95% CI 0.532-14.898).
Quadriceps muscle weakness was related to increased risk of the incidence of radiographic knee OA, but not its progression, in both women and men. Therefore, the clinically important finding of this study is that, in both women and men, maintaining higher quadriceps muscle strength may be one of the most effective prevention methods for incident radiographic knee OA.
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本研究旨在通过纵向研究探讨股四头肌力量与放射学膝关节骨关节炎（OA）之间的因果关系。
本研究纳入了参加第 5 次（2007 年）和第 7 次（2013 年）松代膝关节骨关节炎调查的 488 名受试者的 976 个膝关节。使用股四头肌训练机（QTM-05F，Alcare Co.，Ltd.，东京，日本）测量每位受试者的双侧股四头肌力量。此外，获取负重站立膝关节射线照片，并根据 Kellgren-Lawrence 分级系统对膝关节 OA 进行分级。使用多变量逻辑回归分析评估股四头肌力量与放射学膝关节 OA 的发生率和进展之间的关系。
在校正年龄和体重指数（BMI）后，女性和男性膝关节中股四头肌力量最低的四分位数发生放射学膝关节 OA 的风险高于股四头肌力量最高的四分位数（女性：OR 2.414，95%CI 1.098-5.311；男性：OR 2.774，95%CI 1.053-7.309）。相反，在校正年龄、BMI 和股胫角后，女性和男性膝关节中股四头肌力量最低的四分位数与最高的四分位数相比，放射学膝关节 OA 的进展风险没有差异（女性：OR 1.040，95%CI 0.386-2.802；男性：OR 2.814，95%CI 0.532-14.898）。
在女性和男性中，股四头肌无力与放射学膝关节 OA 的发生率增加相关，但与进展无关。因此，本研究的重要临床发现是，在女性和男性中，保持较高的股四头肌力量可能是预防放射学膝关节 OA 发生的最有效方法之一。
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