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

doi:10.2519/jospt.2019.8945

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 journal › Article › peer-review

9 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 language	English
Pages (from-to)	917-924
Number of pages	8
Journal	Journal of Orthopaedic and Sports Physical Therapy
Volume	49
Issue number	12
DOIs	https://doi.org/10.2519/jospt.2019.8945
State	Published - 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

Access to Document

10.2519/jospt.2019.8945

Cite this

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

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.",

keywords = "HOOS, Increased hip moment, Moment impulse, SHOMRI",

author = "Liao, {Tzu Chieh} and Samaan, {Michael A.} and Tijana Popovic and Jan Neumann and Zhang, {Alan L.} and Link, {Thomas M.} and Sharmila Majumdar and Souza, {Richard B.}",

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 {\textcopyright}2019 Journal of Orthopaedic & Sports Physical Therapy{\textregistered} 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 {\textcopyright} 2019 Journal of Orthopaedic & Sports Physical Therapy{\textregistered}.",

year = "2019",

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doi = "10.2519/jospt.2019.8945",

language = "English",

volume = "49",

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T1 - Abnormal joint loading during gait in persons with hip osteoarthritis is associated with symptoms and cartilage lesions

AU - Liao, Tzu Chieh

AU - Samaan, Michael A.

AU - Popovic, Tijana

AU - Neumann, Jan

AU - Zhang, Alan L.

AU - Link, Thomas M.

AU - Majumdar, Sharmila

AU - Souza, Richard B.

N1 - 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®.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - 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.

AB - 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.

KW - HOOS

KW - Increased hip moment

KW - Moment impulse

KW - SHOMRI

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

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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