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Ann Rheum Dis. Apr 2004; 63(4): 402–407.
PMCID: PMC1754965

Reduced functional performance in the lower extremity predicted radiographic knee osteoarthritis five years later


Background: Reduced quadriceps strength is an early finding in subjects with knee osteoarthritis, but it is not clear whether it is a cause or a consequence of knee osteoarthritis.

Objective: To determine whether reduced functional performance in the lower extremity predicts the incidence or progression of radiographic knee osteoarthritis.

Design: Prospective, epidemiological, population based cohort study.

Patients: 148 subjects (62 women), aged 35–54 (mean 44.8), with chronic knee pain from a population based cohort.

Measurements: Predictors analysed were age, sex, body mass index, baseline knee pain, and three tests of lower extremity functional performance: maximum number of one-leg rises from sitting, time spent walking 300 m, and timed standing on one leg. Weightbearing tibiofemoral knee radiographs were obtained at baseline and after 5 years (median 5.1, range 4.2–6.1), and classified according to Kellgren and Lawrence as no osteoarthritis (Kellgren and Lawrence = 0, n = 94) or prevalent osteoarthritis (Kellgren and Lawrence [gt-or-equal, slanted]1, n = 54).

Results: Fewer one-leg rises (median 17 v 25) predicted incident radiographic osteoarthritis five years later (OR 2.6, 95% CI 1.1 to 6.0). The association remained significant after controlling for age, sex, body mass index, and pain. No significant predictor of radiographic progression in the group with prevalent osteoarthritis was found.

Conclusion: Reduced functional performance in the lower extremity predicted development of radiographic knee osteoarthritis 5 years later among people aged 35–55 with chronic knee pain and normal radiographs at baseline. These findings suggest that a test of one-leg rises may be useful, and interventions aimed at improving functional performance may be protective against development of knee osteoarthritis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
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Figures and Tables

Figure 1
Flow from sample of population at baseline to study cohort at follow up.

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