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Unilateral hip osteoarthritis: The effect of compensation strategies and anatomic measurements on frontal plane joint loading
Author(s) -
Schmidt André,
Meurer Andrea,
Lenarz Katharina,
Vogt Lutz,
Froemel Dara,
Lutz Frederick,
Barker John,
Stief Felix
Publication year - 2017
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.23444
Subject(s) - osteoarthritis , medicine , gait , knee joint , gait analysis , range of motion , joint (building) , physical medicine and rehabilitation , orthodontics , surgery , pathology , architectural engineering , alternative medicine , engineering
In order to reduce pain caused by the affected hip joint, unilateral hip osteoarthritis patients (HOAP) adopt characteristic gait patterns. However, it is unknown if the knee and hip joint loading in the non‐affected (limb non‐affected ) and the affected (limb affected ) limb differ from healthy controls (HC) and which gait parameters correlate with potential abnormal joint loading. Instrumented 3D‐gait analysis was performed on 18 HOAP and 18 sex, age, and height matched HC. The limb non‐affected showed greater first and second peak external hip adduction moments (first HAM: +15%, p = 0.014; second HAM: +15%, p = 0.021, respectively), than seen in HC. In contrast, the second peak external knee adduction moment (KAM) in the limb affected is reduced by about 23% and 30% compared to the limb non‐affected and HC, respectively. Furthermore, our patients showed characteristic gait compensation strategies including reduced peak vertical forces (pvF), a greater foot progression angle (FPA), and reduced knee range of motion (ROM) in the limb affected . The limb affected was 5.6 ± 3.8 mm shorter than the limb non‐affected . Results of stepwise regression analyses showed that increased first pvF explain 16% of first HAM alterations, whereas knee ROM and FPA explain 39% of second KAM alterations. We therefore expect an increased rate of progression of OA in the hip joint of the limb non‐affected and suggest that the shift in the medial‐to‐lateral knee joint load distribution may impact the rate of progression of OA in the limb affected . The level of evidence is III. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1764–1773, 2017.