Weak Thigh Muscles Contribute to Knee Arthritis in Women

MedicalResearch.com Interview with:

Adam Culvenor, PT, PhD

Dr. Adam Culvenor

Adam Culvenor, PT, PhD
Research Fellow,Institute of Anatomy
Paracelsus Medizinische Privatuniversität
Strubergasse Salzburg, Austria

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Thigh muscle weakness, particularly of the knee extensors (quadriceps), is a common feature of people with knee osteoarthritis. Thigh muscle weakness could be a consequence of knee osteoarthritis, or precede knee osteoarthritis development. There is conflicting evidence regarding the role of thigh muscle weakness as a risk factor for incident knee osteoarthritis in both men and women. Thigh muscle specific strength is a measure of muscle quality incorporating both the capacity of the muscle to produce force as well as muscle structure (ie. size, cross-sectional area), and preliminary data suggests this may be a more relevant measure of strength in relation to knee osteoarthritis development.

MedicalResearch.com: What should readers take away from your report?

Response: Deficits in thigh muscle specific strength (both knee extensors and flexors) increased the risk of radiographic knee osteoarthritis over a four year follow-up period in women only, and not in men. This relationship in women was confounded by BMI – a potent risk factor for knee osteoarthritis itself. Looking more specifically at how muscles respond to variations in BMI, differences between men and women may explain our primary result, with more contractile tissue (and strength) being present in men with greater BMI, and apparently more non-contractile (adipose) tissue in women with greater BMI.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: While it is not possible to guarantee that having strong thigh muscles will protect women from developing knee osteoarthritis because there are many other factors that play into the disease, our results suggest that optimizing quadriceps and hamstring strength may help to lower the risk of developing knee osteoarthritis. To target deficits in muscle specific strength (ie. the capacity of the actual muscle fibres within the muscle to produce force), a focus on muscle activation interventions such as muscle biofeedback and neuromuscular stimulation may be appropriate.

MedicalResearch.com: Is there anything else you would like to add?

Response: Our results suggest that the ability of muscle activation interventions, such as muscle biofeedback and neuromuscular stimulation, which attempt to optimize muscle specific strength and in turn reduce the risk of RKOA development, should be a focus of future research.

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Arthritis Care Res (Hoboken). 2017 Feb 8. doi: 10.1002/acr.23182. [Epub ahead of print]
Thigh muscle specific strength and the risk of incident knee osteoarthritis: The influence of sex and greater body mass index.
Culvenor AG1,2, Felson DT3,4, Niu J3, Wirth W1, Sattler M1, Dannhauer T1, Eckstein F1.

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