Objective To update a systematic review on the association between knee extensor muscle weakness and the risk of incident knee osteoarthritis in women and men. Design Systematic review and meta-analysis. Data sources Systematic searches in PubMed, EMBASE, SPORTDiscus, CINAHL, AMED and CENTRAL in May 2021. Eligible criteria for selecting studies Longitudinal studies with at least 2 years follow-up including baseline measure of knee extensor muscle strength, and follow-up measure of symptomatic or radiographic knee osteoarthritis. Studies including participants with known knee osteoarthritis at baseline were excluded. Risk of bias assessment was conducted using six criteria for study validity and bias. Grading of Recommendations Assessments, Development and Evaluation assessed overall quality of evidence. Meta-analysis estimated the OR for the association between knee extensor muscle weakness and incident knee osteoarthritis. Results We included 11 studies with 46 819 participants. Low quality evidence indicated that knee extensor muscle weakness increased the odds of symptomatic knee osteoarthritis in women (OR 1.85, 95% CI 1.29 to 2.64) and in adult men (OR 1.43, 95% CI 1.14 to 1.78), and for radiographic knee osteoarthritis in women: OR 1.43 (95% CI 1.19 to 1.71) and in men: OR 1.39 (95% CI 1.07 to 1.82). No associations were identified for knee injured populations except for radiographic osteoarthritis in men. Discussion There is low quality evidence that knee extensor muscle weakness is associated with incident symptomatic and radiographic knee osteoarthritis in women and men. Optimising knee extensor muscle strength may help to prevent knee osteoarthritis. PROSPERO registration number CRD42020214976.

中文翻译：

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膝关节伸肌无力是膝关节骨性关节炎发展的危险因素：一项更新的系统评价和荟萃分析，包括 46 819 名男性和女性

目的 更新关于膝关节伸肌无力与女性和男性发生膝关节骨关节炎风险之间关系的系统评价。设计系统回顾和荟萃分析。数据来源 2021 年 5 月在 PubMed、EMBASE、SPORTDiscus、CINAHL、AMED 和 CENTRAL 进行系统搜索。选择研究的合格标准 至少 2 年随访的纵向研究，包括膝关节伸肌力量的基线测量，以及膝关节伸肌强度的随访测量症状性或影像学膝关节骨性关节炎。包括基线时已知膝关节骨关节炎的参与者的研究被排除在外。使用六项研究有效性和偏倚标准进行偏倚风险评估。建议评估、制定和评估的分级评估了证据的整体质量。荟萃分析估计了膝伸肌无力与膝关节骨性关节炎之间关联的 OR。结果 我们纳入了 46 819 名参与者的 11 项研究。低质量证据表明，膝关节伸肌无力增加了女性（OR 1.85, 95% CI 1.29 至 2.64）和成年男性（OR 1.43, 95% CI 1.14 至 1.78）以及影像学膝关节骨关节炎的症状性膝关节骨关节炎的几率女性：OR 1.43（95% CI 1.19 至 1.71），男性：OR 1.39（95% CI 1.07 至 1.82）。除了男性的放射学骨关节炎外，没有发现膝关节受伤人群的关联。讨论 低质量的证据表明，膝关节伸肌无力与女性和男性偶发的有症状和影像学膝关节骨关节炎有关。优化膝关节伸肌力量可能有助于预防膝关节骨关节炎。PROSPERO 注册号 CRD42020214976。