Carvalho Maurício Tatsch Ximenes, Pinheiro Victor Hugo Guesser, Alberton Cristine Lima
University Center of the Campanha Region, 2099, Tupy Silveira Avenue - City Center, Bagé, RS, 96400-110, Brazil; Physical Education and Physical Therapy School, Federal University of Pelotas, 625, Luiz de Camões Street - Tablada District, Pelotas, RS, 96055-630, Brazil.
Physical Education and Physical Therapy School, Federal University of Pelotas, 625, Luiz de Camões Street - Tablada District, Pelotas, RS, 96055-630, Brazil.
Ann Phys Rehabil Med. 2025 Jul 8;68(7):101998. doi: 10.1016/j.rehab.2025.101998.
Knee osteoarthritis (OA) is a painful joint condition characterized by changes in quadriceps femoris muscle architecture and quality. Although ultrasound is an emerging tool for evaluating muscle conditions in this population, its usefulness and clinical implications remain unclear.
To investigate the effects of knee OA on quadriceps muscle architecture, summarize ultrasound protocols used in studies, and explore the associations between muscle characteristics with symptoms and physical function.
Searches across 3 electronic databases (PubMed, PEDro, and EMBASE) were performed by 2 independent investigators according to strict inclusion and exclusion criteria.
The findings highlight that ultrasound protocols often lack detailed descriptions, even if there is growing interest in how the quadriceps femoris muscle changes in knee osteoarthritis people, particularly in muscle thickness and echo intensity. The meta-analysis revealed that vastus medialis muscle thickness was significantly lower in individuals with knee OA compared to healthy controls (mean difference:0.52 mm; 95 % CI -1.01 to -0.03; P = 0.037), whereas no significant differences were found for rectus femoris, vastus lateralis, or vastus intermedius thickness. In the qualitative synthesis, the systematic literature analysis showed muscle changes, including a decreased muscle quality in both the vastus medialis and vastus intermedius. Additionally, quadriceps femoris muscle thickness is associated with condition-specific, patient-reported outcomes and functional performance in people with knee OA, whereas there is a relationship between echo intensity and functional performance.
The study highlights the need for standardized ultrasound protocols to capture changes in quadriceps muscle architecture and quality, as some of these changes correlated to patient-reported outcomes measures and functional performance in knee OA people. Finally, we propose a recommendation to improve the measurement of muscle echo intensity in clinical practice.
PROSPERO database (registration number: CRD42023471617).
膝关节骨关节炎（OA）是一种疼痛性关节疾病，其特征是股四头肌的结构和质量发生变化。尽管超声是评估该人群肌肉状况的一种新兴工具，但其效用和临床意义仍不明确。
研究膝关节OA对股四头肌结构的影响，总结研究中使用的超声检查方案，并探讨肌肉特征与症状和身体功能之间的关联。
由两名独立研究人员根据严格的纳入和排除标准，对3个电子数据库（PubMed、PEDro和EMBASE）进行检索。
研究结果表明，尽管人们对膝关节骨关节炎患者股四头肌的变化，特别是肌肉厚度和回声强度越来越感兴趣，但超声检查方案往往缺乏详细描述。荟萃分析显示，与健康对照组相比，膝关节OA患者的股内侧肌厚度显著降低（平均差异：0.52mm；95%CI -1.01至-0.03；P = 0.037），而股直肌、股外侧肌或股中间肌厚度未发现显著差异。在定性综合分析中，系统文献分析显示肌肉有变化，包括股内侧肌和股中间肌的肌肉质量下降。此外，股四头肌厚度与膝关节OA患者的特定病情、患者报告的结局和功能表现相关，而回声强度与功能表现之间存在关联。
该研究强调需要标准化的超声检查方案来捕捉股四头肌结构和质量的变化，因为其中一些变化与膝关节OA患者的患者报告结局指标和功能表现相关。最后，我们提出一项建议，以改进临床实践中肌肉回声强度的测量。
PROSPERO数据库（注册号：CRD42023471617）。
