Assessment of Quadriceps Muscle in Advanced Knee Osteoarthritis and Correlation with Lower Limb Alignment
<i>Background and Objectives</i>: Despite extensive studies of the role of quadriceps and quadriceps/hamstring balance in knee osteoarthritis (OA), the roles of the vastus intermedius, medialis, and lateralis in OA remain unclear. The purpose of this study was to investigate the relation...
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| author | Ki-Cheor Bae Eun-Seok Son Chang-Jin Yon Jubin Park Du-Han Kim |
| author_facet | Ki-Cheor Bae Eun-Seok Son Chang-Jin Yon Jubin Park Du-Han Kim |
| author_sort | Ki-Cheor Bae |
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| description | <i>Background and Objectives</i>: Despite extensive studies of the role of quadriceps and quadriceps/hamstring balance in knee osteoarthritis (OA), the roles of the vastus intermedius, medialis, and lateralis in OA remain unclear. The purpose of this study was to investigate the relationship of lower limb alignment and the ratio of the quadriceps femoris muscle to the knee extensor muscle. <i>Materials and Methods</i>: This study included 50 patients with advanced knee OA (Kellgren/Lawrence grade of 3 or 4) and 25 healthy control persons between June 2021 and May 2022. The osteoarthritis grade and anatomical tibiofemoral angle were measured based on plain radiography and scanography. All participants were divided into normal (0~5°), mild varus (5°~10°), and severe varus (>10°) groups. Using MRI, muscle size was determined by calculating the cross-sectional area (CSA) of the total quadriceps (rectus femoris, vastus intermedius, vastus medialis, and vastus lateralis) and its components. <i>Results</i>: The CSA ratio of the vastus lateralis was significantly smaller in the severe varus group than in the normal or mild varus groups. There was a significant positive correlation between the mechanical tibiofemoral angle and vastus lateralis CSA (<i>ρ</i> = 0.282, <i>p</i> = 0.014) and between the anatomical tibiofemoral angle and vastus lateralis CSA (<i>ρ</i> = 0.294, <i>p</i> = 0.011). There was a significant negative correlation between the mechanical tibiofemoral angle and vastus intermedius CSA (<i>ρ</i> = −0.263, <i>p</i> = 0.023) and between the anatomical tibiofemoral angle and vastus intermedius CSA (<i>ρ</i> = −0.243, <i>p</i> = 0.036). <i>Conclusions</i>: Patients with severe varus alignment exhibited vastus lateralis atrophy. This study highlights vastus lateralis atrophy in severe varus alignment, though causality between atrophy and varus knee OA remains uncertain. We think that patients with severe varus may require strengthening exercises focused on the vastus lateralis before and after surgery for alignment correction. |
| format | Article |
| id | doaj-art-68c7cf34eacd474d91888b3ceb0a62a9 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2024-12-01 |
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| series | Medicina |
| spelling | doaj-art-68c7cf34eacd474d91888b3ceb0a62a92024-12-27T14:38:43ZengMDPI AGMedicina1010-660X1648-91442024-12-016012198310.3390/medicina60121983Assessment of Quadriceps Muscle in Advanced Knee Osteoarthritis and Correlation with Lower Limb AlignmentKi-Cheor Bae0Eun-Seok Son1Chang-Jin Yon2Jubin Park3Du-Han Kim4Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of KoreaDepartment of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of KoreaDepartment of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of KoreaDepartment of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of KoreaDepartment of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Republic of Korea<i>Background and Objectives</i>: Despite extensive studies of the role of quadriceps and quadriceps/hamstring balance in knee osteoarthritis (OA), the roles of the vastus intermedius, medialis, and lateralis in OA remain unclear. The purpose of this study was to investigate the relationship of lower limb alignment and the ratio of the quadriceps femoris muscle to the knee extensor muscle. <i>Materials and Methods</i>: This study included 50 patients with advanced knee OA (Kellgren/Lawrence grade of 3 or 4) and 25 healthy control persons between June 2021 and May 2022. The osteoarthritis grade and anatomical tibiofemoral angle were measured based on plain radiography and scanography. All participants were divided into normal (0~5°), mild varus (5°~10°), and severe varus (>10°) groups. Using MRI, muscle size was determined by calculating the cross-sectional area (CSA) of the total quadriceps (rectus femoris, vastus intermedius, vastus medialis, and vastus lateralis) and its components. <i>Results</i>: The CSA ratio of the vastus lateralis was significantly smaller in the severe varus group than in the normal or mild varus groups. There was a significant positive correlation between the mechanical tibiofemoral angle and vastus lateralis CSA (<i>ρ</i> = 0.282, <i>p</i> = 0.014) and between the anatomical tibiofemoral angle and vastus lateralis CSA (<i>ρ</i> = 0.294, <i>p</i> = 0.011). There was a significant negative correlation between the mechanical tibiofemoral angle and vastus intermedius CSA (<i>ρ</i> = −0.263, <i>p</i> = 0.023) and between the anatomical tibiofemoral angle and vastus intermedius CSA (<i>ρ</i> = −0.243, <i>p</i> = 0.036). <i>Conclusions</i>: Patients with severe varus alignment exhibited vastus lateralis atrophy. This study highlights vastus lateralis atrophy in severe varus alignment, though causality between atrophy and varus knee OA remains uncertain. We think that patients with severe varus may require strengthening exercises focused on the vastus lateralis before and after surgery for alignment correction.https://www.mdpi.com/1648-9144/60/12/1983kneeosteoarthritisquadricepsvarus deformitymuscle atrophy |
| spellingShingle | Ki-Cheor Bae Eun-Seok Son Chang-Jin Yon Jubin Park Du-Han Kim Assessment of Quadriceps Muscle in Advanced Knee Osteoarthritis and Correlation with Lower Limb Alignment Medicina knee osteoarthritis quadriceps varus deformity muscle atrophy |
| title | Assessment of Quadriceps Muscle in Advanced Knee Osteoarthritis and Correlation with Lower Limb Alignment |
| title_full | Assessment of Quadriceps Muscle in Advanced Knee Osteoarthritis and Correlation with Lower Limb Alignment |
| title_fullStr | Assessment of Quadriceps Muscle in Advanced Knee Osteoarthritis and Correlation with Lower Limb Alignment |
| title_full_unstemmed | Assessment of Quadriceps Muscle in Advanced Knee Osteoarthritis and Correlation with Lower Limb Alignment |
| title_short | Assessment of Quadriceps Muscle in Advanced Knee Osteoarthritis and Correlation with Lower Limb Alignment |
| title_sort | assessment of quadriceps muscle in advanced knee osteoarthritis and correlation with lower limb alignment |
| topic | knee osteoarthritis quadriceps varus deformity muscle atrophy |
| url | https://www.mdpi.com/1648-9144/60/12/1983 |
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