Abnormal Joint Loading During Gait in Persons With Hip Osteoarthritis Is Associated With Symptoms and Cartilage Lesions.

Abstract

Hip joint loading in persons with hip osteoarthritis (OA) is not well studied, and its associations with symptoms and lesions are unknown. 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. 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. The OA group exhibited higher peak external hip flexion and adduction moments (<i>P</i><.001) and higher hip flexion, adduction, and external rotation moment impulses (<i>P</i> = .001-.039). Increased hip flexion moment impulses were correlated with worse HOOS subscale scores (<i>r</i> = -0.361 to -0.424, <i>P</i><.05) and worse femoral SHOMRI grades (<i>ρ</i> = 0.256-0.315, <i>P</i><.05). Increased hip external rotation moment impulses were correlated with worse femoral SHOMRI grades (<i>ρ</i> = 0.283-0.372, <i>P</i><.05). 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. <i>J Orthop Sports Phys Ther 2019;49(12):917-924. Epub 14 Oct 2019. doi:10.2519/jospt.2019.8945</i>.