To evaluate the effect of knee effusion on the quadriceps muscle in patients with knee osteoarthritis (OA).Single-blind, randomized, controlled clinical trial.Single medical center.Forty subjects with knee OA were assigned to a experimental (n = 20) or control (n = 20) group.Quadriceps torque and root mean square (RMS) values of surface electromyography (EMG) of the vastus medialis and vastus lateralis muscles were measured during a maximal isometric contraction at 60° knee flexion. Thereafter, 20 mL of normal saline was injected into the knee joint of the experimental group. Quadriceps torque and RMS values were again measured.Five subjects did not complete the study. No significant difference in quadriceps peak torque or RMS of EMG activity was observed at baseline, pre-effusion, or post-effusion measures in either group. The experimental group showed no significant change in quadriceps peak torque or RMS of EMG activity in any period compared with the control group.These results demonstrate that a 20 ml joint effusion did not affect peak torque or RMS values of the quadriceps muscle in patients with knee OA.