Inter-limb strength asymmetry and risk of total knee replacement: a survival analysis.

IF 2.4 4区医学 Q1 REHABILITATION

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-07-04 DOI:10.1097/PHM.0000000000002775

Carson Halliwell, Sophie Rayner, Janie Astephen Wilson, Derek Rutherford, Brett Feltmate, Heather Neyedli, Rebecca Moyer

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Abstract

Objective: The current study explored the association between knee extensor strength asymmetry and the risk of total knee arthroplasty (TKA) in individuals with or at risk of knee osteoarthritis.

Design: This longitudinal cohort study analyzed data from the Osteoarthritis Initiative, including 3,860 individuals with or at risk for knee osteoarthritis. Participants were categorized as having symmetrical or asymmetrical knee extensor strength based on a 10% difference between limbs. Kaplan-Meier curves and Cox regression assessed the risk of TKA over 10-years, adjusting for age, sex, body mass index (BMI), baseline Kellgren-Lawrence grade, absolute weakness, and baseline pain.

Results: Participants with asymmetrical knee extensor strength had a 30% greater risk of undergoing TKA over 10-years compared to those with symmetrical strength (hazard-ratio: 1.30, 95%CI [1.05,1.62]). Limb-specific analyses revealed that a 10% reduction in right and left knee extensor strength were associated with a 40% and 80% increased risk of right and left TKA, respectively.

Conclusion: Knee extensor strength asymmetry was associated with the risk of TKA in individuals with or at risk for knee osteoarthritis. Findings support the need to further examine if an intervention targeted at quadriceps strengthening aimed at achieving and maintaining strength symmetry can reduce TKA risk.

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全膝关节置换术中肢间力量不对称与风险：生存分析。

目的：本研究探讨膝伸肌力量不对称与膝骨关节炎患者或有膝骨关节炎风险的全膝关节置换术（TKA）风险之间的关系。设计：这项纵向队列研究分析了来自骨关节炎倡议的数据，包括3860名患有或有患膝骨关节炎风险的个体。参与者根据四肢之间10%的差异将膝关节伸肌力量分为对称或不对称。Kaplan-Meier曲线和Cox回归评估了10年内TKA的风险，调整了年龄、性别、体重指数（BMI）、基线Kellgren-Lawrence分级、绝对虚弱和基线疼痛。结果：与力量对称的参与者相比，伸膝肌力量不对称的参与者在10年内经历TKA的风险高出30%（风险比：1.30,95%CI[1.05,1.62]）。肢体特异性分析显示，右膝和左膝伸肌力量减少10%，右膝和左膝TKA的风险分别增加40%和80%。结论：膝关节伸肌力量不对称与膝关节骨性关节炎患者发生TKA的风险相关。研究结果支持有必要进一步研究以股四头肌强化为目标的干预是否可以降低TKA风险，以达到和维持力量对称。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Physical Medicine & Rehabilitation 医学-康复医学

CiteScore

4.60

自引率

6.70%

发文量

423

审稿时长

1 months

期刊介绍： American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals. Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).