Reduced muscle radiological density, cross-sectional area, and strength of major hip and knee muscles in 22 patients with hip osteoarthritis
Open accessAbstract
BACKGROUND: Patients with hip osteoarthritis (OA) typically suffer joint pain, and often experience muscular weakness. We hypothesized that substantial atrophy would manifest in multiple muscle groups along the affected limb, resulting in severe muscle dysfunction. PATIENTS AND METHODS: We assessed 22 elderly patients with unilateral OA for maximal voluntary isometric strength of hip and knee muscles using a dynamometer that was developed for the purpose. Cross-sectional area (CSA) and radiological density (RD; in Hounsfield units: HU) of hip and knee muscles were assessed using CT. We determined SF-36, HHS, and EQ-5D. RESULTS: Hip extension, flexion, adduction, abduction, and knee extension strength were reduced (11- 29%; p < 0.01) in the OA limb relative to the healthy limb. Muscle CSA of hip extensors, flexors, adductors, knee extensors and flexors, but not hip abductors, was reduced (11-19%; p < 0.01) in the OA limb, where RD of all muscle groups except hip flexors was reduced (5-15 HU; p < 0.01). The clinical scores confirmed impairment. INTERPRETATION: Major muscles functioning around the hip and knee showed substantial loss of strength and mass, which contributes to the reduced ambulatory capacity of OA patients. Reduced muscle CSA could not fully explain the loss in strength. Infiltration with fat or other non-contractile components, as indicated by a reduced RD, in OA limb muscles was substantial.
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Radiological attenuation of the quadriceps muscle, a valid proxy of contractile density, showed no significant change in transgender women after 12 months of treatment, whereas transgender men demonstrated a +6% increase in contractile density with testosterone supplementation.
“The more novel measure of radiological attenuation of the quadriceps muscle, a valid proxy of contractile density [74, 75], showed no significant change in transgender women after 12 months of treatment, whereas the parallel group of transgender men demonstrated a + 6% increase in contractile density with testosterone supplementation.”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [75]
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- Authors
- Rasch, A., Byström, A. H., Dalen, N., & Berg, H. E.
- Affiliations
- Danderyds sjukhus (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Rasch, Anton
- ORCID
- Berg, Hans E.
- Venue
- Acta Orthopaedica
- Published
- 2007-01
- Volume
- 78
- Issue
- 4
- Pages
- 505-510
- ISSN
- 1745-3674 (ISSN-L)
- 1745-3682
- OpenAlex
- W2125543195
- Cited by
- 215
- References
- 12
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 12 · 2023: 12 · 2022: 12 · 2021: 20 · 2020: 16 · 2019: 13 · 2018: 15 · 2017: 6 · 2016: 10 · 2015: 12 · 2014: 17 · 2013: 9 · 2012: 9
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Acta Orthopaedica (publishedVersion)
- Acta Orthopaedica (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Surgery › Hip disorders and treatments
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Keywords
- hip osteoarthritis, knee osteoarthritis, muscle atrophy, muscle strength, cross-sectional area, muscle density, hip extensors, hip flexors, hip abductors, knee extensors, knee flexors, ambulatory capacity, elderly patients, fatty infiltration
- MeSH terms
- Aged, Female, Hip Joint, Humans, Isometric Contraction, Knee Joint, Male, Middle Aged, Tomography, X-Ray Computed, Osteoarthritis, Hip, Muscle, Skeletal, Muscle Weakness
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