Evaluatıon of hamstrıng/quadrıceps torque ratıos ın patıents wıth gonarthrozıs usıng the ısocınetıc dynamometer and comparıson wıth healthy ındıvıduals

Osteoarthritis (OA) is the most common articular joint disease in the world. Incidence and prevalence of OA increases with age. Knees are one of the commonly affected joints. OA is a chronic disease that results from the deterioration of the balance between proliferative and degradative processes in articular cartilage and subchondral bone. Pain and physical disability are the major symptoms.Several studies have shown the role of muscle dysfunction in the pathogenesis of knee OA . Recent investigations have demonstrated that the conventional torque ratio, calculated using concentric or eccentric contractions (Hamstring concentric/Quadriceps concentric or Hamstring eccentric/Quadriceps eccentric) could not be the best method for evaluation of periarticular knee muscular strength properties. G?t has been suggested that the agonist antagonist strength relationship for knee may be beter described by a functional H/Q ratio (Hcon/Qecc; representative of knee flexion and Qecc/Hcon; representative of knee extension). However, to our knowledge, no existing study describes this functional H/Q ratio in knee OA and compares it with healthy individuals. Therefore, in tour study, we aimed to investigate this ratio and it?s importance for knee OA.Twenty healthy women and twenty women with grade 2 or 3 primer knee OA between the age of 50 and 80 were included in the study. We performed power analysis to calculate the sample size. Concentric and eccentric peak torque of quadriceps and hamstring muscles were evaluated for all individuals in patient and control groups with a Cybex isokinetic device. Individuals performed 5 maximal concentric-eccentric extension and 5 concentric-eccentric flexion for 90°/sn angular velocity. Then functional H/Q ratio is calculated manually.There were no differences between the two groups for age, weight, height, and body mass index. The values of peak torque of hamstring concentric and eccentric and quadriceps concentric for patient group were significantly lower than the control group (p<0,05). No statistically important difference was found for quadriceps eccentric peak torque between two groups (p>0,05). H/Q ratio for extension in patient group was significantly larger than the control group (p<0,05). Whereas the H/Q ratio for flexion in patient group was significantly lower than the control group (p<0,05).In conclusion; we demonstrated the weakness of quadriceps and hamstring muscles in patients with knee OA. Only concentric contraction mode was affected in quadriceps, whereas all concentric and eccentric weakness were found for hamstring muscle in patients with knee OA. Based on these findings, we recommend that the combination of functional H/Q ratio with hamstring and quadriceps muscles concentric and eccentric strength values will help to analyse the knee functions and develop preventive-therapeutic approaches for knee OA.