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Quadriceps Strength and Osteoarthritis Progression in Malaligned and Lax Knees

Leena Sharma, MD; Dorothy D. Dunlop, PhD; September Cahue, BS; Jing Song, MS; and Karen W. Hayes, PhD
[+] Article, Author, and Disclosure Information

From Northwestern University, Chicago, Illinois.

Grant Support: By National Institutes of Health grant AR-30692, National Institutes of Health/National Center for Research Resources grant RR-00048, and the Arthritis Foundation.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Leena Sharma, MD, Division of Rheumatology, Feinberg School of Medicine, Northwestern University Medical School, 300 East Superior Avenue, Tarry Building 3-715, Chicago, IL 60611.

Current Author Addresses: Dr. Sharma and Ms. Cahue: Department of Medicine, Feinberg School of Medicine, Northwestern University Medical School, 300 East Superior Avenue, Tarry Building 3-715, Chicago, IL 60611.

Dr. Dunlop and Ms. Song: Institute for Health Services Research and Policy Studies, Northwestern University, 339 East Chicago Avenue, Wieboldt Hall, Room 717, Chicago, IL 60611.

Dr. Hayes: Department of Physical Therapy and Human Movement Sciences, Northwestern University Medical School, 645 North Michigan Avenue, Suite 1100, Chicago, IL 60611.

Author Contributions: Conception and design: L. Sharma, S. Cahue, K.W. Hayes.

Analysis and interpretation of the data: L. Sharma, D.D. Dunlop, J. Song.

Drafting of the article: L. Sharma, S. Cahue.

Critical revision of the article for important intellectual content: L. Sharma, D.D. Dunlop, K.W. Hayes.

Final approval of the article: L. Sharma, D.D. Dunlop, K.W. Hayes.

Provision of study materials or patients: S. Cahue.

Statistical expertise: D.D. Dunlop, J. Song.

Obtaining of funding: L. Sharma.

Administrative, technical, or logistic support: L. Sharma, J. Song, K.W. Hayes.

Collection and assembly of data: L. Sharma, S. Cahue, K.W. Hayes.

Ann Intern Med. 2003;138(8):613-619. doi:10.7326/0003-4819-138-8-200304150-00006
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We longitudinally followed 237 participants, of whom 7 (3%) did not return at 18 months; 5 had died, and 2 could not be reached. Of the 230 remaining participants, 171 did not have advanced osteoarthritis in any compartment of either knee. Among these 171 participants (126 women, 45 men), mean age (±SD) was 64.0 ± 11.0 years and mean BMI (±SD) was 30.0 ± 5.5 kg/m2. At baseline, no participants had a Kellgren and Lawrence grade of 0 for right knee osteoarthritis severity, 11 had a grade of 1, 110 had a grade of 2, 50 had a grade of 3, and none had a grade of 4. Sixty-three participants had no joint space narrowing in the right knee at baseline, 60 had mild narrowing, 48 had moderate narrowing, and none had severe narrowing. Mean right-limb quadriceps strength (±SD) was 51.8 ± 28.5 ft-lb, and mean laxity (±SD) was 5.32 ± 2.03 degrees. Right knees were varus in 79 participants, valgus in 71 participants, and neutral in 21 participants. No participants had a knee effusion. These assessments were similar in the left knees. All analyses incorporated data from both knees, using generalized estimating equations. We excluded 14 knees that had previously been replaced, leaving 328 knees for analysis.

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Summary for Patients

Upper Leg Muscle Strength and Osteoarthritis

The summary below is from the full report titled “Quadriceps Strength and Osteoarthritis Progression in Malaligned and Lax Knees.” It is in the 15 April 2003 issue of Annals of Internal Medicine (volume 138, pages 613-619). The authors are L. Sharma, D.D. Dunlop, S. Cahue, J. Song, and K.W. Hayes.


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