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Anatomic correlates of reduced hip extension during walking in individuals with mild‐moderate radiographic hip osteoarthritis
Authors:Deepak Kumar  Cory Wyatt  Ko Chiba  Sonia Lee  Lorenzo Nardo  Thomas M. Link  Sharmila Majumdar  Richard B. Souza
Affiliation:1. Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California;2. Department of Orthopedic Surgery, Nagasaki University School of Medicine, Japan;3. Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, China Basin, San Francisco, California;4. Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco
Abstract:To identify radiographic and MR features of hip osteoarthritis (OA) related to reduced hip extension during walking. 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 1.35 m/s using 3‐D motion capture. All subjects completed Hip disability and Osteoarthritis Outcome Score (HOOS), timed up and go, and 6 min 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. 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. Reduced hip extension and greater hip flexion during walking are present in high functioning (HOOS > 85%) individuals with mild‐moderate hip OA, and are associated with cartilage lesions. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:527–534, 2015.
Keywords:gait  cartilage  Labrum  HOOS  6 minute walk test
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