Is Quadriceps-Strengthening Exercises (QSE) in MedialCompartment Knee Osteoarthritis with Neutral and Varus Malalignment a Paradox? – A Risk-Appraisal of StrengthTraining on Disease Progression
https://doi.org/10.5704/MOJ.2403.010
- Author:
Garg R
1
;
Krishna A
1
;
Daga R
2
;
Arora S
1
;
Puri S
3
;
Kumar M
1
Author Information
1. Department of Orthopaedics, Maulana Azad Medical College, New Delhi, India
2. Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India
3. Department of Radiodiagnosis, Govind Ballabh Pant Hospital, New Delhi, India
- Publication Type:Journal Article
- Keywords:
knee osteoarthritis, medial compartment, quadriceps exercises, disease progression
- From:Malaysian Orthopaedic Journal
2024;18(No.1):73-83
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The present inquiry seeks to investigate
whether the current regimens of QSEs (QuadricepsStrengthening Exercises) aggravate the disease while
mitigating symptoms.
Materials and methods: A comparative study was
conducted on 32 patients with medial compartment
osteoarthritis of knees. While the neutral group of 16 patients
was constituted of those with an anatomical-lateral-femorotibial-angle (aFTA) 176-180º, varus group comprised an
equal number of patients with an aFTA >180º. A home-based
12-week strength-training program involving weekly visits
to hospital for supervised sessions was administered. The
outcome measures were visual-analog-scale (VAS), medial
patello-femoral joint tenderness (MPFJT), time-up-and-gotest (TUGT), stair-climb test, step test, WOMAC, IKDC
scores, aFTA, hip-knee-ankle (HKA) angle, lateral-tibiofemoral-joint-separation (LTFJS), and horizontal-distancefrom-centre-of-knee-to-Mikulicz-line.
Results: There was a significant increase in quadriceps
strength (p<0.01) in both groups. Values for neutral group
with VAS score (p=0.01), MPFJT (p=0.01), TUGT (p=0.01),
timing of the stair climb test (p=0.01), WOMAC (p<0.01),
and IKDC (p=0.03) were better compared to varus group
with VAS score (p=0.13), MPFJT (p=0.03), TUGT (p=0.90),
timing of stair climb test (p=0.68), WOMAC (p<0.02), and
IKDC (p=0.05). Varus group also showed an increase in
aFTA and LTFJS in 12 patients, increase in HKA in 11, and
increase in horizontal distance from the centre of knee to the
Mikulicz line in 7 patients.
Conclusion: The present study brings to the fore the
paradoxical role played by QSEs in management of medial
knee OA. While there is a radiological progression of the
disease in both neutral and varus mal-aligned knees more so
in the latter than the former.
- Full text:202408071650410809116.2024my1354.pdf
