Muscle strength and osteoarthritis of the knee: a systematic review and meta‐analysis of longitudinal studies

Review written by Stephen King info

Key Points

  1. Low knee extensor and flexor strength increased the risk of worsening tibiofemoral osteoarthritis (OA) in those 'at risk' of OA.
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Lower-limb muscle weakness is common in individuals with knee osteoarthritis (OA). Muscle strengthening interventions are a cornerstone of clinical guideline recommendations to improve knee symptoms and functional disability. However, the relationship between muscle strength and future structural OA outcomes is less clear.

The objective of this study was to evaluate the sex-specific association between low knee extensor and flexor muscle strength and the risk of knee structural worsening (i.e. OA).

Lower-limb muscle weakness is common in individuals with knee osteoarthritis.
If we instil the importance of developing strength early in our patients (particularly females who present with knee pain), we can minimize the impact of OA as they age.


A systematic search strategy was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using combined Medical Subject Headings (MeSH) and keywords in the title/abstract related to knee/patellofemoral, osteoarthritis, risk factor and muscle strength.

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