Clinical Rheumatology

, Volume 38, Issue 3, pp 719–725 | Cite as

Influence of the severity of knee osteoarthritis on the association between leg muscle mass and quadriceps strength: the SPSS-OK study

  • Osamu Wada
  • Noriaki KuritaEmail author
  • Tsukasa Kamitani
  • Naoki Nakano
  • Kiyonori Mizuno
Original Article


Quadriceps strength is important for maintaining functional movement in patients with knee osteoarthritis (OA). We aimed to examine whether knee OA severity weakened the magnitude of the associations between leg muscle mass, quadriceps strength, and functional movement. Screening for People Suffering Sarcopenia in Orthopedic cohort of Kobe study (SPSS-OK) was a single-center cross-sectional study. We recruited 611 patients with knee OA. Leg muscle mass was determined by bioimpedance and used as a proxy for quadriceps muscle mass. Quadriceps strength and indices of functional movement (assessed by the functional activities category of the new Knee Society Score questionnaire [KSS] and the Timed Up and Go [TUG] test) were measured. Knee OA severity was determined by the Kellgren-Lawrence radiographic grade. A series of general linear models was fitted with adjustment for confounding variables. The increase in quadriceps strength per leg associated with a 1-kg increase in leg mass per leg was 7.29 Nm, 5.43 Nm, and 3.77 Nm among patients with knee OA grade 1/2, 3, and 4, respectively (P for interaction = 0.003). A 1-Nm increase in quadriceps strength per leg was associated with both a 0.14 point increase in KSS movement score and a 0.05 s decrease in TUG, regardless of knee OA severity (P for interaction 0.430 and 0.323). Severe knee OA may reduce efficiency in the exertion of quadriceps strength by leg muscle mass even when the amount of muscle mass remains unchanged.


Knee osteoarthritis severity Muscle mass Muscle strength 



The authors greatly thank the following research assistant and medical staff members for their assistance in collecting the clinical information used in this study Takehiro Kaga, Tomohiro Oka, Yoriko Tamura, Hiroshi Nishi, Yuichi Isaji, Yutaka Sato, Tomohiro Takagi, Kaho Shibata, Maho Wakai, Chisato Shindoh, Kenta Hirose, Takuma Ota, Tatsuya Arita, Yuuki Ikawa, Tsuyoshi Fukui, Riuji Nakagawa, Taisuke Hayashida, Shuto Fujii, Keisuke Yoneya, Kazuaki Mori (Anshin Hospital, Kobe), Lisa Shimokawa (Fukushima Medical University Hospital, Fukushima-city, Fukushima).

Funding information

This study was supported by JSPS KAKENHI (Grant Number JP15K16518).

Compliance with ethical standards



Supplementary material

10067_2018_4337_MOESM1_ESM.pptx (38 kb)
Supplementary Fig. 1 (PPTX 37 kb)
10067_2018_4337_MOESM2_ESM.doc (84 kb)
ESM 1 (DOC 84 kb)


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  • Osamu Wada
    • 1
  • Noriaki Kurita
    • 2
    • 3
    Email author
  • Tsukasa Kamitani
    • 4
  • Naoki Nakano
    • 1
    • 5
  • Kiyonori Mizuno
    • 1
  1. 1.Anshin HospitalKobeJapan
  2. 2.Department of Innovative Research and Education for Clinicians and Trainees (DiRECT)Fukushima Medical University HospitalFukushima CityJapan
  3. 3.Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical UniversityFukushimaJapan
  4. 4.Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto UniversityKyotoJapan
  5. 5.Department of Trauma & Orthopaedics, Addenbrooke’s HospitalCambridge University Hospital NHS Foundation TrustCambridgeUK

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