January 2025 CME Activity: Relationship Between 2 Years of Muscle Strength Decrease and Volume Loss of Menisci and Cartilage According to Knee Pain in Mild and Moderate Knee Osteoarthritis-Relationship Between 2 Years of Muscle Strength Decrease and Volume Loss of Menisci and Cartilage According to Knee Pain in Mild and Moderate Knee Osteoarthritis

Relationship Between 2 Years of Muscle Strength Decrease and Volume Loss of Menisci and Cartilage According to Knee Pain in Mild and Moderate Knee Osteoarthritis

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This study investigates the relationship between changes in muscle strength and cartilage volume over two years in individuals with mild to moderate knee osteoarthritis (OA), with a focus on the role of knee pain as assessed by the Western Ontario McMaster University Osteoarthritis Index (WOMAC). Data for 279 participants was sourced from the Osteoarthritis Initiative, assessing muscle strength via isometric strength tests and cartilage volume through MRI imaging.<br /><br />Key findings highlighted a significant association between decreased quadriceps strength and medial meniscus degeneration in patients experiencing greater levels of knee pain (WOMAC pain > 2). Additionally, the study found that the balance between quadriceps and hamstrings might play a protective role in maintaining knee function, especially in those with weaker quadriceps and higher pain levels.<br /><br />The study revealed that in mild to moderate knee OA, disease progression is mainly characterized by patellofemoral cartilage loss and meniscal degeneration. Notably,  the decrease in extensor strength was linked with medial meniscus volume loss, suggesting that maintaining muscle strength is crucial for minimizing tissue degeneration in OA patients, particularly in those experiencing significant knee pain.<br /><br />Furthermore, changes in the extensor/flexor ratio were positively correlated with changes in physical function, suggesting that maintaining muscle balance may help preserve function in individuals with deficient quadriceps strength and substantial knee pain. This suggests that strength training could be of therapeutic benefit to mitigate muscle loss associated with progression of knee OA.<br /><br />This research reinforces the importance of lower limb muscle strength in managing knee OA and suggests further investigation into muscle strengthening as a treatment strategy for reducing pain and cartilage degeneration in knee OA patients. However, the study acknowledges limitations, such as its short follow-up and retrospective design, indicating the need for further longitudinal studies to substantiate these findings.

Keywords

muscle strength

cartilage volume

knee osteoarthritis

WOMAC index

quadriceps strength

meniscal degeneration

MRI imaging

extensor/flexor ratio

muscle balance

strength training