Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (11): 61-67.doi: 10.6040/j.issn.1671-7554.0.2025.0319

• Clinical Medicine • Previous Articles    

Mendelian randomization analysis of the causal association between pain and muscle strength in knee osteoarthritis

ZHOU Kun1,2*, LIU Ting2*, JIANG Yanju2, HU Zekai3, LI Yujia4, FENG Wuyi2, HUANG Jili2, YE Wangquan2, ZHAO Xiaofeng2, HU Jun1,5   

  1. 1. School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;
    2. Department of Rehabilitation Medicine, Shanghai Zhongye Hospital, Shanghai 200941, China;
    3. Department of Rehabilitation Medicine, Second Rehabilitation Hospital of Shanghai, Shanghai 200441, China;
    4. Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200403, China;
    5. Department of Traditional Chinese Medicine Rehabilitation, Second Rehabilitation Hospital of Shanghai, Shanghai 200441, China
  • Published:2025-11-28

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Abstract: Objective To investigate the decline in knee flexor and extensor muscle strength in patients with knee osteoarthritis(KOA)through clinical trials and to explore the causal relationship between KOA and thigh muscle volume using genome-wide association studies(GWAS), as well as to analyse the characteristics and potential factors influencing the decrease in thigh muscle strength in KOA patients. Methods Female patients aged 50 to 80 years diagnosed with KOA who visited the orthopaedic clinic of Shanghai Zhongye Hospital from January 2023 to December 2024 were selected and divided into a bilateral knee pain group(n=19)and a unilateral knee pain group(n=33). Healthy adults were recruited as a healthy control group(n=65). Analysis of variance was used to compare the maximum peak torque of the knee flexor and extensor muscles among 3 groups. Bidirectional two-sample Mendelian randomization analysis was performed using inverse variance weighting, MR-Egger, and weighted median methods to examine the association between knee osteoarthritis, pain, and muscle volume in the anterior and posterior thigh. Results The maximum torque for knee extension and flexion in the bilateral knee pain group was significantly different from that of the healthy control group(P<0.05); peak torque on the unaffected and affected sides in the unilateral knee pain group was significantly different from that of the healthy control group(P<0.001); the difference between the unaffected and affected sides in the unilateral knee pain group was not statistically significant(P>0.05). There was no correlation between knee osteoarthritis and pain and volume of the anterior thigh muscles(KOA: P=0.16; pain: P=0.08), while there was a negative correlation with the volume of the posterior thigh muscles(KOA: P=0.01; pain: P<0.05). There was no negative correlation between the volume of the anterior thigh muscles and the volume of the posterior thigh muscles with KOA and pain. Conclusion Patients with KOA and pain symptoms exhibit a significant decrease in the maximum torque of the flexor muscle group. A reduction in posterior thigh muscle volume may be one of the causes of decreased flexor muscle strength, while a decrease in extensor muscle strength is not related to anterior thigh muscle volume, indicating that factors influencing decreased flexor and extensor muscle strength differ in patients with KOA and pain symptoms.

Key words: Knee osteoarthritis, Isokinetic muscle strength, Pain, Muscle volume, Mendelian randomization

CLC Number: 

  • R684.3
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