Objective: The aim of this study was to explore the longitudinal associations between baseline quadriceps strength and knee joint structural abnormalities in knee osteoarthritis (KOA). Methods: This study is a longitudinally observational study based on Osteoarthritis Initiative (OAI) cohort, including men and women aged 45–79. Quadriceps strength was measured by isometric knee extension testing at baseline. Knee joint structural abnormalities, including cartilage damage, bone marrow lesions (BMLs), effusion-synovitis and Hoffa-synovitis, were evaluated by Magnetic Resonance Imaging Osteoarthritis Knee Score (MOAKS) at baseline and 1-year follow-up. Generalized estimating equations were employed to examine the associations between quadriceps strength and knee structural abnormalities. All analyses were stratified by sex. Results: One thousand three hundred thirty-eight participants (523 men and 815 women) with a mean age of 61.8 years and a mean BMI of 29.4 kg/m² were included in this study. For men, no significantly longitudinal association of quadriceps strength with structural abnormalities was detected. In contrast, quadriceps strength was significantly and negatively associated with changes in cartilage damage and BMLs in lateral patellofemoral joint (PFJ) (cartilage damage: OR: 0.91, 95% CI 0.84 to 0.99, P = 0.023; BMLs: OR: 0.85, 95% CI 0.74 to 0.96, P = 0.011) and effusion-synovitis (OR = 0.88, 95% CI 0.78 to 0.99, P = 0.045) among females longitudinally. Higher quadriceps strength was significantly associated with less progression of lateral PFJ cartilage damage, BMLs and effusion-synovitis in females. Conclusions: Higher quadriceps strength was associated with changes in cartilage damage and BMLs within the lateral PFJ and effusion-synovitis among females, suggesting the potential protective role of quadriceps strength on joint structures in women.

Objective The aim of this study was to explore the association between quadriceps strength and synovitis in the knee osteoarthritis (KOA). Methods This study was derived from the Osteoarthritis Initiative (OAI) cohort which recruited adults with or at risk of KOA. Knees with complete records of isometric quadriceps strength, effusion-synovitis and Hoffa-synovitis assessments were included. Quadriceps strength was measured isometrically at baseline. Effusion-synovitis and Hoffa-synovitis were measured using Magnetic Resonance Imaging Osteoarthritis Knee Score (MOAKS) at baseline, 1-year and 2-year follow-ups. Generalized estimating equations were used to analyze the associations of baseline quadriceps strength with the effusionsynovitis and Hoffa-synovitis changes in multivariable analyses. Additionally, analyses were stratified on synovitis-driven inflammatory phenotype. Results 1513 knees were included in this study. 61.0% of the subjects were female, with an average age of 61.9 years and mean BMI of 29.4 kg/m². In the whole population, baseline quadriceps strength was negatively associated with the baseline effusion-synovitis and follow-up changes in effusion-synovitis (OR: 0.77-0.86), but no significant association was observed in terms of Hoffa-synovitis. Stratified by synovitis-driven inflammatory phenotypes, baseline quadriceps strength was significantly associated with follow-up changes in effusion-synovitis in the population with existed effusion-synovitis (OR: 0.75-0.79), but not in Hoffa-synovitis. Conclusion Higher baseline quadriceps strength was negatively associated with the changes in effusion-synovitis instead of Hoffa-synovitis, especially in the population with existed effusion-synovitis. Our finding suggested a potential protective role of quadriceps in effusion-synovitis.

Implantable medical devices face critical failure risks due to biofouling and thrombosis. A major challenge is developing coatings that combine long‐term mechanical stability with robust anti‐biofouling efficacy under dynamic vascular conditions. To address this, we introduce a novel dendritic nano‐based slippery coating (DNSC), fabricated by encapsulating carboxyl silicone oil within amino dendritic silica nanoparticles and co‐embedding them in an epoxy resin matrix. The dendritic architecture enhances nanoparticle dispersion in the matrix and establishes mechanical interlock. Coupled with electrostatic interactions between amine and carboxyl groups, this design ensures stable lubricant immobilization, improving mechanical durability while providing exceptional slipperiness. Under simulated blood flow, DNSC demonstrated unprecedented and sustained resistance to protein, bacterial, cellular, and platelet adhesion for over 15 days. Mechanistic studies confirmed that anti‐adhesion arises from physical slippage rather than bioactive release. Besides, in vitro and in vivo evaluations showed significant thrombosis inhibition without notable inflammation or tissue damage, confirming excellent biocompatibility. Through synergistic innovation in material architecture and interfacial engineering, this work successfully resolves the longstanding trade‐off between mechanical robustness and surface slippery. The proposed DNSC offers a promising surface modification strategy for blood‐contacting devices, integrating durability, anti‐fouling performance, and biosafety to enhance device reliability and longevity.