title: The longitudinal relationship between thigh muscle mass and the development of knee osteoarthritis.
abstract: OBJECTIVE
  Greater quadriceps strength has been found to reduce risk for symptomatic knee osteoarthritis (SxKOA) and knee joint space narrowing (JSN). However, this finding could relate to muscle mass or activation pattern. The purpose of this study was to assess whether greater thigh muscle mass protects against (1) incident radiographic (RKOA), (2) incident SxKOA or (3) worsening of knee JSN by 30-month follow-up.
  
  
  METHODS
  Multicenter Osteoarthritis (MOST) study participants, who underwent dual-energy X-ray absorptiometry (DXA) at the Iowa site were included. Thigh muscle mass was calculated from DXA image sub-regions. Sex-stratified, knee-based analyses controlled for incomplete independence between limbs within subjects. The effect of thigh lean mass and specific strength as predictors of ipsilateral RKOA, SxKOA and worsening of JSN were assessed, while controlling for age, body mass index (BMI), and history of knee surgery.
  
  
  RESULTS
  A total of 519 men (948 knees) and 784 women (1453 knees) were included. Mean age and BMI were 62 years and 30 kg/m(2). Thigh muscle mass was not associated with risk for RKOA, SxKOA or knee JSN. However, in comparison with the lowest tertile, those in the highest and middle tertiles of knee extensor specific strength had a lower risk for SxKOA and JSN [odds ratio (OR) 0.29-0.68].
  
  
  CONCLUSIONS
  Thigh muscle mass does not appear to confer protection against incident or worsening knee OA. These findings suggest that future studies of risk for knee OA should focus on the roles of knee extensor neuromuscular activation and muscle physiology, rather than the muscle mass.
authors.affiliation: Department of Orthopaedics & Rehabilitation, The University of Iowa Carver College of Medicine, Iowa City, IA, United States. segal-research@uiowa.edu
authors.forename: N A
authors.initials: NA
authors.lastname: Segal
authors.forename: C
authors.initials: C
authors.lastname: Findlay
authors.forename: K
authors.initials: K
authors.lastname: Wang
authors.forename: J C
authors.initials: JC
authors.lastname: Torner
authors.forename: M C
authors.initials: MC
authors.lastname: Nevitt
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015992:Body Mass Index; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011379:Prognosis; D013848:Thigh