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Thigh muscle anatomical cross\u2010sectional areas (ACSAs) were determined at baseline using axial magnetic resonance imaging scans. Isometric extensor and flexor muscle strength was measured at baseline, and specific strength (strength \u00f7 ACSA) was calculated. Logistic regression assessed the risk of incident RKOA associated with muscle specific\u2010strength (with and without adjustment for BMI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lower knee extensor\u2013 and flexor\u2013specific strength significantly increased the risk of incident RKOA in women but not in men (odds ratio 1.47 [95% confidence interval (95% CI) 1.10\u20131.96] and 1.41 [95% CI 1.06\u20131.89], respectively). The significant relationship in women was lost after adjustment for BMI. Lower specific strength was associated with higher BMI in women (r\u2009=\u2009\u22120.29, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), but not in men, whereas absolute strength was associated with BMI in men (r\u2009=\u20090.28, <jats:italic>P<\/jats:italic>\u2009=\u20090.001), but not in women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Lower thigh muscle specific\u2010strength predicts incident RKOA in women, with this relationship being confounded by BMI. The sex\u2010specific relationship between muscle specific\u2010strength and BMI provides a possible explanation why women with muscle\u2010strength deficits typically have a poorer prognosis than men with similar strength deficits.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23182","type":"journal-article","created":{"date-parts":[[2017,2,8]],"date-time":"2017-02-08T00:04:49Z","timestamp":1486512289000},"page":"1266-1270","source":"Crossref","is-referenced-by-count":43,"title":["Thigh Muscle Specific\u2010Strength and the Risk of Incident Knee Osteoarthritis: The Influence of Sex and Greater Body Mass Index"],"prefix":"10.1002","volume":"69","author":[{"given":"Adam G.","family":"Culvenor","sequence":"first","affiliation":[{"name":"Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria, and La Trobe University Bundoora Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"Felson","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine, Boston, Massachusetts, and University of Manchester and Central Manchester NHS Foundation Trust Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingbo","family":"Niu","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Wirth","sequence":"additional","affiliation":[{"name":"Paracelsus Medical University Salzburg and Nuremberg Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Sattler","sequence":"additional","affiliation":[{"name":"Paracelsus Medical University Salzburg and Nuremberg Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torben","family":"Dannhauer","sequence":"additional","affiliation":[{"name":"Paracelsus Medical University Salzburg and Nuremberg Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Eckstein","sequence":"additional","affiliation":[{"name":"Paracelsus Medical University Salzburg and Nuremberg Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.10.008"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20835"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20588"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2012.08.019"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199811)41:11<1951::AID-ART9>3.0.CO;2-9"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1002\/art.39540","article-title":"Thigh muscle strength predicts knee replacement risk independent of radiographic disease and pain in women: data from the Osteoarthritis Initiative","volume":"68","author":"Culvenor AG","year":"2016","journal-title":"Arthritis Rheum"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2010.12.011"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.155119"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0000000000000113"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2012.02.635"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2010.02.002"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2013.05.016"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bor.0000240365.16842.4e"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20726"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000534"}],"container-title":["Arthritis Care &amp; 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