Associations among knee muscle strength, structural damage, and pain and mobility in individuals with osteoarthritis and symptomatic meniscal tear

BMC Musculoskelet Disord. 2018 Jul 27;19(1):258. doi: 10.1186/s12891-018-2182-8.


Background: Sufficient lower extremity muscle strength is necessary for performing functional tasks, and individuals with knee osteoarthritis demonstrate thigh muscle weakness compared to controls. It has been suggested that lower muscle strength is associated with a variety of clinical features including pain, mobility, and functional performance, yet these relationships have not been fully explored in patients with symptomatic meniscal tear in addition to knee osteoarthritis. Our purpose was to evaluate the associations of quadriceps and hamstrings muscle strength with structural damage and clinical features in individuals with knee osteoarthritis and symptomatic meniscal tear.

Methods: We performed a cross-sectional study using baseline data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial. We assessed structural damage using Kellgren-Lawrence grade and the magnetic resonance imaging osteoarthritis knee score (MOAKS) for cartilage damage. We used the Knee Injury and Osteoarthritis Outcomes Score (KOOS) to evaluate pain, symptoms, and activities of daily living (ADL), and the Timed Up and Go (TUG) test to assess mobility. We assessed quadriceps and hamstrings strength using a hand-held dynamometer and classified each into quartiles (Q). We used Chi square tests to evaluate the association between strength and structural damage; and separate analysis of covariance models to establish the association between pain, symptoms, ADL and mobility with strength, after adjusting for demographic characteristics (age, sex and BMI) and structural damage.

Results: Two hundred fifty two participants were evaluated. For quadriceps strength, subjects in the strongest quartile scored 14 and 13 points higher on the KOOS Pain and ADL subscales, respectively, and completed the TUG two seconds faster than subjects in the weakest quartile. For hamstrings strength, subjects in the strongest quartile scored 13 and 14 points higher on the KOOS pain and ADL subscales, respectively, and completed the TUG two seconds faster than subjects in the weakest quartile. Strength was not associated with structural damage.

Conclusions: Greater quadriceps and hamstrings muscle strength was associated with less pain, less difficulty completing activities of daily living, and better mobility. These relationships should be evaluated longitudinally.

Keywords: Hamstrings; KOOS; activities of daily living; Quadriceps; Timed up and go.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Cross-Sectional Studies
  • Female
  • Humans
  • Knee Joint / physiopathology
  • Male
  • Middle Aged
  • Mobility Limitation*
  • Muscle Strength / physiology*
  • Osteoarthritis, Knee / epidemiology*
  • Osteoarthritis, Knee / physiopathology
  • Pain / diagnosis
  • Pain / epidemiology*
  • Pain / physiopathology
  • Pain Measurement / methods
  • Quadriceps Muscle / physiopathology
  • Range of Motion, Articular / physiology
  • Tibial Meniscus Injuries / diagnosis
  • Tibial Meniscus Injuries / epidemiology*
  • Tibial Meniscus Injuries / physiopathology