Muscle Strength and Power Improve Despite Small Increase in Quadriceps Cross-Sectional Area in Massive Knee Joint Destruction: A Two-Year Follow-Up Case Report.
5 affiliations
- 1Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile.
- 2Transversal Group on Rare, Uncommon, and Orphan Diseases (GERPOH-UChile), Faculty of Medicine, University of Chile, Santiago 8380453, Chile.
- 3Kinesiology Unit, Hospital San José, Santiago 8380419, Chile.
- 4Traumatology Unit, Hospital San José, Santiago 8380419, Chile.
- 5Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 València, Spain.
Abstract
Joint damage may result from different conditions, including osteoarthritis, rheumatoid arthritis, infection, and haemophilic arthropathy. Long-term effects of resistance training in individuals with massive joint destruction remain poorly documented. We report a case of a patient with haemophilia and massive joint destruction who completed a two-year home-based knee-extension programme. Training was performed twice weekly and included biofeedback-guided isometric knee extension at 80% of maximal voluntary isometric strength, followed by a closed-chain exercise using elastic resistance. Structural knee damage and quadriceps cross-sectional area (CSA) were assessed using computed tomography (CT). Pain, knee-extension strength, quadriceps CSA, and 30-s sit-to-stand performance were assessed at baseline and at two-year follow-up. Pain during active knee extension decreased from 6/10 to 2/10, and pain during daily activities decreased from 6/10 to 4/10. Knee-extension strength increased from 7 kgf to 20 kgf, representing a 186% increase. The 30-s sit-to-stand performance improved from 14 to 22 repetitions and estimated relative sit-to-stand muscle power increased from 3.4 to 5.3 W/kg, representing a 57% increase. Notably, quadriceps CSA increased by only 6% (from 1954.9 to 2078.6 mm²). No bleeding episodes or other adverse events were reported. After two years of strength training, marked gains in muscle strength and power were observed despite a small increase in quadriceps cross-sectional area. This case report highlights the need for future long-term follow-up studies of strength training in individuals with advanced joint damage.
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BibTeX
@article{cruzmontecinos2026muscle,
title = {{Muscle Strength and Power Improve Despite Small Increase in Quadriceps Cross-Sectional Area in Massive Knee Joint Destruction: A Two-Year Follow-Up Case Report.}},
author = {Carlos Cruz-Montecinos and Rodrigo Núñez-Cortés and Pablo Becerra-Yañez and Andrés Oyarzún and Joaquín Calatayud},
journal = {Muscles (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/muscles5040075},
url = {https://europepmc.org/article/MED/42924647},
note = {CC BY},
}
RIS
TY - JOUR
TI - Muscle Strength and Power Improve Despite Small Increase in Quadriceps Cross-Sectional Area in Massive Knee Joint Destruction: A Two-Year Follow-Up Case Report.
AU - Carlos Cruz-Montecinos
AU - Rodrigo Núñez-Cortés
AU - Pablo Becerra-Yañez
AU - Andrés Oyarzún
AU - Joaquín Calatayud
PY - 2026
DA - 2026/10/13
JO - Muscles (Basel, Switzerland)
DO - 10.3390/muscles5040075
UR - https://europepmc.org/article/MED/42924647
AB - Joint damage may result from different conditions, including osteoarthritis, rheumatoid arthritis, infection, and haemophilic arthropathy. Long-term effects of resistance training in individuals with massive joint destruction remain poorly documented. We report a case of a patient with haemophilia and massive joint destruction who completed a two-year home-based knee-extension programme. Training was performed twice weekly and included biofeedback-guided isometric knee extension at 80% of maximal voluntary isometric strength, followed by a closed-chain exercise using elastic resistance. Structural knee damage and quadriceps cross-sectional area (CSA) were assessed using computed tomography (CT). Pain, knee-extension strength, quadriceps CSA, and 30-s sit-to-stand performance were assessed at baseline and at two-year follow-up. Pain during active knee extension decreased from 6/10 to 2/10, and pain during daily activities decreased from 6/10 to 4/10. Knee-extension strength increased from 7 kgf to 20 kgf, representing a 186% increase. The 30-s sit-to-stand performance improved from 14 to 22 repetitions and estimated relative sit-to-stand muscle power increased from 3.4 to 5.3 W/kg, representing a 57% increase. Notably, quadriceps CSA increased by only 6% (from 1954.9 to 2078.6 mm²). No bleeding episodes or other adverse events were reported. After two years of strength training, marked gains in muscle strength and power were observed despite a small increase in quadriceps cross-sectional area. This case report highlights the need for future long-term follow-up studies of strength training in individuals with advanced joint damage.
SN - 2813-0413
ER -