From the Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China (ML, YN, YZ, YW, YL, LW, BS); and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (KL).
Am J Phys Med Rehabil. 2022 Sep 1;101(9):836-842. doi: 10.1097/PHM.0000000000001922. Epub 2021 Nov 17.
It has been demonstrated that high extensor strength decreases knee osteoarthritis symptomatic progression. However, few studies have detected a significant association between extensor strength and structural progression.
Participants in the Osteoarthritis Initiative with both muscle strength and meniscus assessment, Kellgren-Lawrence grade 1 or less, and body mass index less than 30 were enrolled. In a separate-sex analysis, participants were divided into the high and low strength groups, referring to the median value. Meniscus progression according to the Magnetic Resonance Imaging Osteoarthritis Knee Score was compared between the two groups at 12 mos (393 females and 229 males) and 24 mos (340 females and 208 males).
In females, less overall medial meniscus progression (11.1% [17/153] vs. 23.2% [32/138], P = 0.04), less medial meniscal medial extrusion (5.2% [8/155] vs. 12.5% [18/144], P = 0.04), and less medial meniscal anterior extrusion progression (0% [0/108] vs. 5.3% [6/113], P = 0.03) were present in the high strength group at 24 mos. In males, no significant difference was detected between the high strength group and the low strength group.
In females, higher extensor muscle strength was associated with a decreased risk of medial meniscus progression in medial and anterior extrusion.
研究表明，伸肌力量较高可减缓膝关节骨关节炎的症状进展。然而，很少有研究发现伸肌力量与结构进展之间存在显著关联。
本研究纳入了 Osteoarthritis Initiative 中既有肌肉力量又有半月板评估、Kellgren-Lawrence 分级为 1 级或更低且体重指数小于 30 的参与者。在一项性别分离分析中，根据中位数将参与者分为高力量组和低力量组。在 12 个月（393 名女性和 229 名男性）和 24 个月（340 名女性和 208 名男性）时，比较两组的 MRI 骨关节炎膝关节评分（Magnetic Resonance Imaging Osteoarthritis Knee Score）的半月板进展情况。
在女性中，高力量组的总内侧半月板进展较少（11.1% [153/138] 比 23.2% [32/138]，P = 0.04），内侧半月板内侧突出较少（5.2% [155/144] 比 12.5% [18/144]，P = 0.04），内侧半月板前突出进展较少（0% [108/113] 比 5.3% [6/113]，P = 0.03）。在男性中，高力量组与低力量组之间未检测到显著差异。
在女性中，较高的伸肌力量与内侧和前侧半月板突出的内侧半月板进展风险降低相关。
