Anatomic correlates of reduced hip extension during walking in individuals with mild‐moderate radiographic hip osteoarthritis

Abstract

Purpose To identify radiographic and MR features of hip osteoarthritis (OA) related to reduced hip extension during walking. Methods Sixty six subjects, were stratified into those with (n = 36, KL = 2, 3) and without (n = 30, KL = 0, 1) radiographic hip OA. Cartilage and labrum lesions were graded semi-quantitatively on hip MRI. Alpha angle and lateral center edge (LCE) angle were measured. Sagittal kinematics and kinetics were calculated during walking at speed of 1.3 m/sec using 3-D motion capture. All subjects completed Hip disability and Osteoarthritis Outcome Score (HOOS), timed up and go, and 6 minute walk tests. Variables were compared between the two groups using one-way ANOVA (adjusting for age). Correlations of radiographic and MR parameters with peak hip extension were calculated. Results The OA group was older, had greater pain, and limitation of function. They also had lower peak hip extension and higher peak hip flexion; and worse acetabular and femoral cartilage lesions. Peak hip extension and flexion correlated with KL grade, cartilage lesions in the inferior and posterior femur. Conclusions Reduced hip extension and greater hip flexion during walking are present in high functioning (HOOS > 85%) individuals with mild-moderate hip OA, and is associated with cartilage lesions.

Joint Loading in the Sagittal Plane During Gait Is Associated With Hip Joint Abnormalities in Patients With Femoroacetabular Impingement

“…26,31 Each participant was instructed to cover as much distance as possible while walking during a 6-minute time frame. 16 The total distance, measured in meters, achieved by each participant was recorded and used to compare physical performance between both the FAI and control groups.…”

Acetabular cartilage defects cause altered hip and knee joint coordination variability during gait

“…A total of 93 participants were recruited for this study. Since previous studies using vector coding to analyze the effects of radiographic hip OA have not been performed, previously published data on hip sagittal plane excursion in those with (KL grade 2 or 3) and without (KL grade 0 or 1) radiographic hip OA (Kumar et al, 2015) was used as inputs into a power analysis. The power analysis performed in the current study used an alpha and a power of 0.05 and 95%, respectively.…”

“…A marker set consisting of 41 retro-reflective markers was used to collect three dimensional position data (Kumar et al, 2014; Kumar et al, 2015). Specifically, fifteen retro-reflective markers placed at anatomical landmarks on both lower extremities were used to define joint centers.…”

“…are widely used in understanding the effects of hip joint OA on gait patterns (Eitzen et al, 2012; Foucher et al, 2012; Hurwitz et al, 1998; Hurwitz et al, 1997; Watelain et al, 2001). Specifically, hip joint sagittal plane range of motion was reduced in those with hip OA when compared to healthy controls (Eitzen et al, 2012; Hurwitz et al, 1998; Hurwitz et al, 1997; Kumar et al, 2015; Zeni et al, 2014). Those with hip OA also demonstrated reduced hip extension in late stance (Eitzen et al, 2012; Watelain et al, 2001; Zeni et al, 2014).…”

“…Despite a greater amount of pain and disability, measures of physical performance did not demonstrate any significant relationships with MRI-based findings and suggests that further analysis is needed to evaluate the relationships between hip MRI abnormalities and hip joint movement patterns (Kumar et al, 2013). Also, weak associations between acetabular cartilage lesions and gait parameters were observed and suggest that a study with a larger sample size is needed to confirm these findings (Kumar et al, 2015). Therefore, it may be possible that traditional planar kinematic analyses may not be sensitive enough to detect changes that may occur with pathologies such as acetabular cartilage lesions.…”