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Abstract：
BACKGROUND: Decreased strength and increased stiffness of the quadriceps have been associated with a higher risk of developing knee osteoarthritis (OA) in elders. Dynamic joint stiffness (DJS) represents collective resistance from active and passive knee structures for dynamic knee motions. Elevated sagittal knee DJS has been associated with worsening of cartilage loss in knee OA patients. Altered quadriceps properties may affect DJS, which could be a mediator for associations between quadriceps properties and knee OA. Hence, this study aimed to examine whether DJS and quadriceps properties would be associated with the development of clinical knee OA over 24 months, and to explore the mediation role of DJS in associations between quadriceps properties and knee OA.
METHODS: This was a prospective cohort study with 162 healthy community-dwelling elders. Gait analysis was conducted to compute DJS during the loading response phase. Quadriceps strength and stiffness were evaluated using a Cybex dynamometer and shear-wave ultrasound elastography, respectively. Knee OA was defined based on clinical criteria 24 months later. Logistic regression with generalized estimating equations was used to examine the association between quadriceps properties and DJS and incident knee OA. Mediation analysis was performed to explore the mediation role of DJS in associations between quadriceps properties and the incidence of knee OA.
RESULTS: A total of 125 participants (65.6 ± 4.0 years, 58.4% females) completed the 24-month follow-up, with 36 out of 250 knees identified as clinical knee OA. Higher DJS (OR = 1.86, 95%CI: 1.33-2.62), lower quadriceps strength (1.85, 1.05-3.23), and greater quadriceps stiffness (1.56, 1.10-2.21) were significantly associated with a higher risk of clinical knee OA. Mediation analysis showed that the DJS was not a significant mediator for the associations between quadriceps properties and knee OA.
CONCLUSIONS: Higher sagittal knee dynamic joint stiffness, lower quadriceps strength, and greater quadriceps stiffness are potential risk factors for developing clinical knee OA in asymptomatic elders. Associations between quadriceps properties and knee OA may not be mediated by dynamic joint stiffness. Interventions for reducing increased passive properties of the quadriceps and knee joint stiffness may be beneficial for maintaining healthy knees in the aging population.
METHODS: This was a prospective cohort study with 162 healthy community-dwelling elders. Gait analysis was conducted to compute DJS during the loading response phase. Quadriceps strength and stiffness were evaluated using a Cybex dynamometer and shear-wave ultrasound elastography, respectively. Knee OA was defined based on clinical criteria 24 months later. Logistic regression with generalized estimating equations was used to examine the association between quadriceps properties and DJS and incident knee OA. Mediation analysis was performed to explore the mediation role of DJS in associations between quadriceps properties and the incidence of knee OA.
RESULTS: A total of 125 participants (65.6 ± 4.0 years, 58.4% females) completed the 24-month follow-up, with 36 out of 250 knees identified as clinical knee OA. Higher DJS (OR = 1.86, 95%CI: 1.33-2.62), lower quadriceps strength (1.85, 1.05-3.23), and greater quadriceps stiffness (1.56, 1.10-2.21) were significantly associated with a higher risk of clinical knee OA. Mediation analysis showed that the DJS was not a significant mediator for the associations between quadriceps properties and knee OA.
CONCLUSIONS: Higher sagittal knee dynamic joint stiffness, lower quadriceps strength, and greater quadriceps stiffness are potential risk factors for developing clinical knee OA in asymptomatic elders. Associations between quadriceps properties and knee OA may not be mediated by dynamic joint stiffness. Interventions for reducing increased passive properties of the quadriceps and knee joint stiffness may be beneficial for maintaining healthy knees in the aging population.
摘要：
背景：在老年人中，股四头肌的强度降低和刚度增加与发展为膝骨关节炎（OA）的风险较高有关。动态关节刚度（DJS）表示来自动态膝关节运动的主动和被动膝关节结构的集体阻力。在膝OA患者中,矢状膝DJS升高与软骨损失的恶化相关。股四头肌属性改变可能会影响DJS，这可能是股四头肌性能和膝关节OA之间关联的中介。因此，这项研究旨在检查DJS和股四头肌的特性是否与临床膝关节OA的发展相关超过24个月，并探讨DJS在股四头肌特性与膝关节OA关系中的中介作用。
方法：这是一项前瞻性队列研究，对162名健康社区老年人进行了研究。在加载响应阶段进行步态分析以计算DJS。使用Cybex测力计和剪切波超声弹性成像评估股四头肌强度和刚度，分别。24个月后根据临床标准定义膝关节OA。使用具有广义估计方程的逻辑回归来检查股四头肌特性与DJS和入射膝关节OA之间的关联。进行中介分析以探讨DJS在股四头肌特性与膝关节OA发生率之间的关系中的中介作用。
结果：总共125名参与者（65.6±4.0年，58.4%的女性)完成了24个月的随访，250个膝盖中有36个被确定为临床膝关节OA。较高的DJS（OR=1.86，95CI：1.33-2.62），下股四头肌强度（1.85，1.05-3.23），和更大的股四头肌僵硬度(1.56,1.10-2.21)与更高的临床膝关节OA风险显著相关。中介分析表明，DJS不是股四头肌特性与膝关节OA之间关联的显着中介。
结论：矢状膝关节动态关节刚度较高，股四头肌力量较低,和更大的股四头肌僵硬是无症状老年人发生临床膝关节OA的潜在危险因素。股四头肌特性与膝关节OA之间的关联可能不是由动态关节刚度介导的。用于减少股四头肌的增加的被动特性和膝关节刚度的干预措施可能有益于在老年人群中保持健康的膝盖。
方法：这是一项前瞻性队列研究，对162名健康社区老年人进行了研究。在加载响应阶段进行步态分析以计算DJS。使用Cybex测力计和剪切波超声弹性成像评估股四头肌强度和刚度，分别。24个月后根据临床标准定义膝关节OA。使用具有广义估计方程的逻辑回归来检查股四头肌特性与DJS和入射膝关节OA之间的关联。进行中介分析以探讨DJS在股四头肌特性与膝关节OA发生率之间的关系中的中介作用。
结果：总共125名参与者（65.6±4.0年，58.4%的女性)完成了24个月的随访，250个膝盖中有36个被确定为临床膝关节OA。较高的DJS（OR=1.86，95CI：1.33-2.62），下股四头肌强度（1.85，1.05-3.23），和更大的股四头肌僵硬度(1.56,1.10-2.21)与更高的临床膝关节OA风险显著相关。中介分析表明，DJS不是股四头肌特性与膝关节OA之间关联的显着中介。
结论：矢状膝关节动态关节刚度较高，股四头肌力量较低,和更大的股四头肌僵硬是无症状老年人发生临床膝关节OA的潜在危险因素。股四头肌特性与膝关节OA之间的关联可能不是由动态关节刚度介导的。用于减少股四头肌的增加的被动特性和膝关节刚度的干预措施可能有益于在老年人群中保持健康的膝盖。
