Do persons with asymmetric hip pain or radiographic hip OA have worse pain and structure outcomes in the knee opposite the more affected hip? Data from the Osteoarthritis Initiative

Abstract

Purpose to determine if asymmetry between hips in pain or radiographic osteoarthritis (RHOA) is associated with worse pain and joint space narrowing (JSN) at baseline and longitudinally in knees contralateral to more affected hips. Methods We studied 279 participants in the Osteoarthritis Initiative with baseline asymmetry between hips in pain and 483 with asymmetry in RHOA none of whom had a hip replacement for ≥4 years after baseline. RHOA assessed from pelvis radiographs was categorized as none, possible or definite and hip pain on most days of a month in the past year as present/absent. Knee pain (WOMAC scale) and JSN (fixed flexion radiographs) were categorized as none, mild and moderate-severe. We compared knees contralateral and ipsilateral to more affected hips on baseline knee pain and JSN using clustered multinomial regression and on change in knee pain and JSN over 4–5 years using generalized linear and logistic estimating equations. Results Knees contralateral to painful hips had less baseline pain (“moderate-severe” vs. “none”, relative risk ratio [RRR]: 0.39, 95% CI = 0.27–0.57), but greater baseline JSN (“moderate-severe” vs. “none”, RRR: 1.62, 95% CI = 1.09–2.38) and greater worsening of pain during follow-up (p = 0.001). Knees contralateral to hips with worse RHOA had nonsignificant trends for greater baseline JSN (p = 0.10) and JSN progression (p = 0.17). Conclusion These findings provide limited support for the hypothesis that early asymmetry in hip pain and RHOA is associated with worse pain and structural outcomes in knees contralateral to the more affected hip.

Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement

“…Higher CF on the contralateral (non-operated) side in the second half of stance compared to the ipsilateral side confirm the results of other studies (Shakoor et al, 2003;Foucher and Wimmer, 2012;Wesseling et al, 2018), although not all studies reported significant differences between patients (ipsilateral or contralateral) and healthy controls (Wesseling et al, 2018) so that a surplus load cannot be confirmed. The present results do support studies reporting a higher risk for the development of OA in the contralateral knee joint after THR (Shakoor et al, 2002;Umeda et al, 2009;Gillam et al, 2013;Jungmann et al, 2015;Joseph et al, 2016) since patients are walking with an asymmetrical limb load. However, these studies only report more structural damage and progression of degenerative findings in the contralateral knee and do not specify the medial or lateral knee compartment.…”

Development and Validation of a Multitask Deep Learning Model for Severity Grading of Hip Osteoarthritis Features on Radiographs

“…Clinical readings were specifically performed for this study, whereas OAI readings were performed for an ancillary OAI study (11). Readers were blinded to clinical information and other imaging results.…”

iPhone Sensors in Tracking Outcome Variables of the 30-Second Chair Stand Test and Stair Climb Test to Evaluate Disability: Cross-Sectional Pilot Study

“…Patients diagnosed with osteoarthritis experience a decline in physical function and often report difficulty performing activities of daily living (ADL) [ 6 ]. Recent work has shown that osteoarthritis patients place increased compensatory stress on their unaffected weight-bearing joints during ADL, a vicious cycle that makes them susceptible to further damage and worsened severity of disease [ 7 - 9 ].…”