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Assessment of Quadriceps Muscle in Advanced Knee Osteoarthritis and Correlation with Lower Limb Alignment

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Author(s)
Ki-Cheor BaeEun-Seok SonChang-Jin YonJubin ParkDu-Han Kim
Keimyung Author(s)
Bae, Ki CheorSon, Eun SeokYon, Chang JinKim, Du Han
Department
Dept. of Orthopedic Surgery (정형외과학)
Journal Title
Medicina (Kaunas)
Issued Date
2024
Volume
60
Issue
12
Keyword
kneeosteoarthritisquadricepsvarus deformitymuscle atrophy
Abstract
Background and Objectives:
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.

Materials and Methods:
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.

Results:
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 (ρ = 0.282, p = 0.014) and between the anatomical tibiofemoral angle and vastus lateralis CSA (ρ = 0.294, p = 0.011). There was a significant negative correlation between the mechanical tibiofemoral angle and vastus intermedius CSA (ρ = −0.263, p = 0.023) and between the anatomical tibiofemoral angle and vastus intermedius CSA (ρ = −0.243, p = 0.036).

Conclusions:
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.
Keimyung Author(s)(Kor)
배기철
손은석
연창진
김두한
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1648-9144
Source
https://www.mdpi.com/1648-9144/60/12/1983
DOI
10.3390/medicina60121983
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/46033
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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