Effect of Quadriceps Strength and Proprioception on Risk for Knee Osteoarthritis

SEGAL, NEIL A.1; GLASS, NATALIE A.1; FELSON, DAVID T.2; HURLEY, MICHAEL3; YANG, MEI2; NEVITT, MICHAEL4; LEWIS, CORA E.5; TORNER, JAMES C.1

Medicine & Science in Sports & Exercise: November 2010 - Volume 42 - Issue 11 - pp 2081-2088
doi: 10.1249/MSS.0b013e3181dd902e
Applied Sciences

Purpose: Impaired quadriceps strength and joint position sense (JPS) have been linked with knee osteoarthritis (OA) cross-sectionally. Although neither has been independently associated with incident radiographic OA, their combination may mediate risk. The purpose of this study was to determine whether better sensorimotor function protects against the development of incident radiographic or symptomatic knee OA.

Methods: The Multicenter Osteoarthritis study is a longitudinal study of adults aged 50-79 yr at high risk for knee OA. Participants underwent bilateral, weight-bearing, fixed-flexion radiographs, JPS acuity tests, and isokinetic quadriceps strength tests. The relationships between combinations of the tertiles of sex-specific baseline peak strength and mean JPS and development of incident radiographic (Kellgren-Lawrence (KL) grade ≥2) or symptomatic knee OA (KL grade ≥2 and frequent knee pain or stiffness) at a 30-month follow-up were evaluated. Secondary analyses defined JPS as the variance during the 10 JPS trials and also assessed the interaction of strength and JPS in predicting each outcome.

Results: The study of incident radiographic knee OA included 1390 participants (age = 61.2 ± 7.9 yr and body mass index = 29.4 ± 5.1 kg·m−2), and the study of incident symptomatic knee OA included 1829 participants (age = 62.2 ± 8.0 yr and body mass index = 30.0 ± 5.4 kg·m−2). Greater strength at baseline protected against incident symptomatic but not radiographic knee OA regardless of JPS tertile. There was no significant relationship between the strength-JPS interaction and the development of radiographic or symptomatic knee OA.

Conclusions: The finding that quadriceps strength protected against incident symptomatic but not radiographic knee OA regardless of JPS tertile suggests that strength may be more important than JPS in mediating risk for knee OA.

1The University of Iowa, Iowa City, IA; 2Boston University, Boston, MA; 3King's College London, London, England, UNITED KINGDOM; 4University of California at San Francisco, San Francisco, CA; and 5University of Alabama at Birmingham, Birmingham, AL

Address for correspondence: Neil A. Segal, M.D., M.S., Departments of Orthopaedics and Rehabilitation, Radiology, and Epidemiology, University of Iowa, 200 Hawkins Dr., 0728 JPP, Iowa City, IA 52242-1088; E-mail: segal-research@uiowa.edu.

Submitted for publication January 2010.

Accepted for publication March 2010.

©2010The American College of Sports Medicine