Abnormal joint loading during gait in persons with hip osteoarthritis is associated with symptoms and cartilage lesions

Tzu Chieh Liao, Michael A. Samaan, Tijana Popovic, Jan Neumann, Alan L. Zhang, Thomas M. Link, Sharmila Majumdar, Richard B. Souza

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

BACKGROUND: Hip joint loading in persons with hip osteoarthritis (OA) is not well studied, and its associations with symptoms and lesions are unknown. OBJECTIVES: To determine whether hip joint loading differs between people with and without radiographic hip OA, and to identify its associations with patients' symptoms and cartilage morphology. METHODS: Forty-eight patients (28 male; mean ± SD age, 56.0 ± 12.2 years) with hip OA and 95 controls (40 male; age, 43.2 ± 13.6 years) participated in this cross-sectional analysis. Pelvic radiographs, questionnaires, magnetic resonance imaging (MRI), and gait analysis were conducted. The Hip disability and Osteoarthritis Outcome Score (HOOS) was used to assess symptoms. Cartilage morphology was graded on MRI scans using the Scoring Hip Osteoarthritis with Magnetic Resonance Imaging (SHOMRI) system. Biomechanical variables included peak external hip joint moment (Newton meters per kilogram) and moment impulses (Newton meters times milliseconds per kilogram) in all planes. Generalized estimating equations were used to compare the biomechanical characteristics between groups. In the patients with OA, associations of moment impulses with HOOS and SHOMRI scores were assessed with partial correlations. RESULTS: The OA group exhibited higher peak external hip flexion and adduction moments (P<.001) and higher hip flexion, adduction, and external rotation moment impulses (P = .001-.039). Increased hip flexion moment impulses were correlated with worse HOOS subscale scores (r = -0.361 to -0.424, P<.05) and worse femoral SHOMRI grades (ρ = 0.256-0.315, P<.05). Increased hip external rotation moment impulses were correlated with worse femoral SHOMRI grades (ρ = 0.283-0.372, P<.05). CONCLUSION: Persons with hip OA exhibited abnormally high hip joint loads during walking, and high loads were associated with worse self-reported symptoms and cartilage morphology.

Original languageEnglish
Pages (from-to)917-924
Number of pages8
JournalJournal of Orthopaedic and Sports Physical Therapy
Volume49
Issue number12
DOIs
StatePublished - Dec 1 2019

Bibliographical note

Funding Information:
1Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA. 2Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY. 3Technical University Munich, Munich, Germany. 4Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA. 5Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA. The study protocol was approved by the Institutional Review Board at the University of California San Francisco. Funding was provided by grants P50 AR060752, K24 AR072133, R01-AR069006, and F32 AR069458, awarded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the US National Institutes of Health, and by grant KL2TR001996, awarded by the National Center for Advancing Translational Sciences of the National Institutes of Health. The authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article. Address correspondence to Dr Tzu-Chieh Liao, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94710. E-mail: tzu-chieh.liao@ucsf.edu U Copyright ©2019 Journal of Orthopaedic & Sports Physical Therapy®

Funding Information:
Funding was provided by grants P50 AR060752, K24 AR072133, R01-AR069006, and F32 AR069458, awarded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the US National Institutes of Health, and by grant KL2TR001996, awarded by the National Center for Advancing Translational Sciences of the National Institutes of Health.

Publisher Copyright:
Copyright © 2019 Journal of Orthopaedic & Sports Physical Therapy®.

Keywords

  • HOOS
  • Increased hip moment
  • Moment impulse
  • SHOMRI

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

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