Department of Rehabilitation Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 1046, Kansas City, KS, 66160, USA.
Department of Biostatistics and Epidemiology, Boston University, Boston, MA, USA.
Osteoarthritis Cartilage. 2022 Jun;30(6):823-831. doi: 10.1016/j.joca.2022.03.002. Epub 2022 Mar 18.
This study aimed to determine longitudinal associations, including sex-specific differences, between greater knee flexor antagonist coactivation and worsening cartilage morphology in knees with or at risk for osteoarthritis (OA).
Baseline measurements were collected at the 60-month visit of a longitudinal osteoarthritis study following community-dwelling participants (MOST). Knee flexor and extensor muscle activity were measured with surface electromyography during a maximal isokinetic knee extension task. MRI analyzed knee cartilage morphology at baseline and 24-month follow-up. Multivariable adjusted logistic regression models were used to assess associations between coactivation level and cartilage morphology worsening.
Analysis of 373 women (mean ± SD age 67.4 ± 7.3 years and BMI 29.7 ± 5.0 kg/m) and 240 men (66.5 ± 7.8 years and 29.9 ± 4.5 kg/m) revealed that women had greater medial (P < 0.001), lateral (P < 0.001), and combined (P < 0.001) hamstring coactivation than men. In both sexes, combined hamstring coactivation was associated with patellofemoral cartilage morphology worsening [1.23 (1.02, 1.49)] and to a less significant degree with whole knee cartilage morphology worsening [1.21 (0.98, 1.49)]. In men, greater combined hamstring coactivation was associated with increased risk for whole knee [1.59 (1.06, 2.39)] and patellofemoral [1.38 (1.01, 1.88)] cartilage morphology worsening and point estimates suggested association between medial hamstring coactivation and medial tibiofemoral cartilage morphology worsening. No significant associations were detected between greater hamstring coactivation and cartilage morphology worsening in women.
These findings suggest a longitudinal relationship between antagonist hamstring coactivation during isokinetic knee extensor testing and worsening of cartilage morphology over 24 months in men with or at risk for knee OA.
本研究旨在确定膝关节伸肌拮抗剂协同收缩与膝关节骨关节炎（OA）或有 OA 风险的膝关节软骨形态恶化之间的纵向关联，包括性别特异性差异。
这项纵向 OA 研究在社区居住参与者（MOST）的 60 个月随访时进行了基线测量。在最大等速膝关节伸展测试中，使用表面肌电图测量膝关节屈肌和伸肌的肌肉活动。在基线和 24 个月随访时，通过 MRI 分析膝关节软骨形态。使用多变量调整逻辑回归模型来评估协同收缩水平与软骨形态恶化之间的关联。
对 373 名女性（平均年龄 67.4 ± 7.3 岁，BMI 29.7 ± 5.0 kg/m）和 240 名男性（66.5 ± 7.8 岁，BMI 29.9 ± 4.5 kg/m）进行分析后发现，女性的内侧（P < 0.001）、外侧（P < 0.001）和联合（P < 0.001）腘绳肌协同收缩均大于男性。在两性中，联合腘绳肌协同收缩与髌股关节软骨形态恶化相关[1.23（1.02，1.49）]，与全膝关节软骨形态恶化的相关性较低[1.21（0.98，1.49）]。在男性中，较大的联合腘绳肌协同收缩与全膝关节[1.59（1.06，2.39）]和髌股关节[1.38（1.01，1.88）]软骨形态恶化的风险增加相关，且点估计表明内侧腘绳肌协同收缩与内侧胫骨股骨软骨形态恶化之间存在关联。在女性中，没有发现较大的腘绳肌协同收缩与软骨形态恶化之间存在显著关联。
这些发现提示在男性膝关节 OA 或有 OA 风险的患者中，等速膝关节伸展测试中拮抗肌腘绳肌协同收缩与 24 个月内软骨形态恶化之间存在纵向关系。
