Thigh muscle cross-sectional areas and strength in knees with early vs knees without radiographic knee osteoarthritis: a between-knee, within-person comparison

Abstract

Objective: To compare cross-sectional and longitudinal side-differences in thigh muscle anatomical cross-sectional areas (ACSAs), muscle strength, and specific strength (strength/ACSA), between knees with early radiographic change vs knees without radiographic knee osteoarthritis (RKOA), in the same person.

Design: 55 (of 4796) Osteoarthritis Initiative (OAI) participants fulfilled the inclusion criteria of early RKOA in one limb (definite tibiofemoral osteophytes; no radiographic joint space narrowing [JSN]) vs no RKOA (no osteophyte; no JSN) in the contralateral limb. ACSAs of the thigh muscles and quadriceps heads were determined using axial MRIs at 33%/30% femoral length (distal to proximal). Isometric extensor and flexor muscle strength were measured (Good Strength Chair). Baseline quadriceps ACSA and extensor (specific) strength represented the primary analytic focus, and 2-year changes of quadriceps ACSAs the secondary focus.

Results: No statistically significant side-differences in quadriceps (or other thigh muscle) ACSAs, muscle strength, or specific strength were observed between early RKOA vs contralateral limbs without RKOA (P ≥ 0.44), neither in men nor in women. The 2-year reduction in quadriceps ACSA in limbs with early RKOA was -0.9 ± 6% (mean ± standard deviation) vs -0.5 ± 6% in limbs without RKOA (statistical difference P = 0.85).

Conclusion: Our results do not provide evidence that early unilateral radiographic changes, i.e., presence of osteophytes, are associated with cross-sectional or longitudinal differences in quadriceps muscle status compared with contralateral knees without RKOA. At the stage of early unilateral RKOA there thus appears to be no clinical need for countervailing a potential dys-balance in quadriceps ACSAs and strength between both knees.

Keywords: Cross-sectional area; Knee osteoarthritis; Magnetic resonance imaging; Muscle; Strength.

Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Figures

Figure 1

A Coronal localizer image: 15 continuous axial slices of the thigh have been acquired. B. Participants (right top). For the current study we selected participants with early radiographic knee osteoarthritis (RKOA) in one knee and no RKOA in the contralateral knee on fixed-flexion X-rays (right top). C–D. Axial cross-sectional MRIs with segmented muscles. Anatomical cross-sectional areas of the quadriceps (pink), hamstrings (red), and adductors (yellow) have been segmented at 33% of femoral length (from distal to proximal) (C). ACSAs of the individual quadriceps heads vastus medialis (brown), vastus intermedius (turquoise), vastus lateralis (yellow), and rectus femoris (purple) have been segmented at 30% of femoral length (from proximal to distal) (D).