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The purpose of this study was to examine whether changes in knee extensor strength mediate the association between changes in knee extension ROM and self-report physical function.
Our results suggest that changes (pre to post TKA) in knee extensor strength mediated the association between changes in knee extension ROM and self-report physical function.
Mediation analyses, adjusted for clinicodemographic measures, revealed that the association between changes in knee extension ROM and SF-36 physical function was mediated by changes in knee extensor strength.
Controlling for covariates, the mediation effect of knee extensor strength on the association between changes in knee extension ROM and physical function was statistically significant (path axb = 0.13; 95% CI, 0.05 to 0.23).
For example, our results provide additional evidence that the association between changes in knee pain and BML volume may be more pronounced among knees with no or small baseline BMLs [ 11].
Because the interrelation between knee extensor strength and knee extension ROM is possible and important to understand clinically, we initiated the present study to examine whether changes in knee extensor strength mediate the association between changes in knee extension ROM and self-report physical function in a large group of patients before and following a TKA.
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There was neither any association between change in knee alignment and change in KOOS pain over time, crude analysis 0.3 point (95% CI -0.6 - 1.2), adjusted analysis 0.4 points (95% CI 0.6 - 1.4).
However, the association between radiological changes in knee OA and the severity of pain or the level of disability is not straightforward.
Pearson's correlation coefficient was used to determine the correlation between knee extensor strength and knee extensor moment, and to determine the correlation between the changes in knee kinetics/kinematics and the change in self-reported Sport and Recreational function according to the KOOS questionnaire.
Very little is known about the relation between BMLs and other changes in knee structures in asymptomatic, clinically healthy populations.
If validated, this relation may allow physicians to use the assessment of pain, perhaps in combination with a biomarker such as CTX-II, as a surrogate for other measures of disease progression This study is one of the first to show a correlation between symptoms and joint structure changes in knee OA.
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