Knee extensor muscle weakness is a risk factor for the development of knee osteoarthritis: an updated systematic review and meta-analysis including 46 819 men and women

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…