Tateuchi H, Koyama Y, Akiyama H, Goto K, So K, Kuroda Y, Ichihashi N
Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Osteoarthritis Cartilage. 2017 Aug;25(8):1291-1298. doi: 10.1016/j.joca.2017.02.796. Epub 2017 Feb 21.
To investigate whether higher daily cumulative hip moment at baseline is associated with subsequent radiographic progression of hip osteoarthritis (OA) over 12 months.
Fifty patients with secondary hip OA, excluding patients with end-stage hip OA, participated in this prospective cohort study. Joint space width (JSW) of the hip was measured at baseline and 12 months later. With radiographic progression of hip OA (>0.5 mm/year in JSW) as dependent variable (yes/no), univariable and multivariable logistic regression analyses were performed to assess the association between load-related parameters during gait (i.e., peak hip moment, hip moment impulse, and daily cumulative hip moment [product of hip moment impulse and mean steps/day]) and hip OA progression with and without adjustment for age, body weight, and minimum JSW.
Of the 50 patients (47.4 ± 10.7 years old), 21 (42.0%) were classified into the progression group. The higher daily cumulative hip moment in the frontal plane at baseline was statistically significantly associated with radiographic progression of hip OA (adjusted odds ratio (OR) [95% confidence interval (CI)], 1.34 [1.06-1.70]; P = 0.013). The higher daily cumulative hip moment in the sagittal plane was also approaching significance in its association with hip OA progression (adjusted OR, 1.80 [0.99-3.26]; P = 0.052).
In the female patients with secondary hip OA, higher daily cumulative hip moment, particularly in the frontal plane, was a predictor of radiographic progression of hip OA over 12 months. Reduction in daily cumulative hip moment by modification in gait and physical activity may potentially slow hip OA progression.
研究基线时较高的每日累积髋部力矩是否与髋骨关节炎(OA)在12个月内的后续影像学进展相关。
50例继发性髋OA患者(不包括终末期髋OA患者)参与了这项前瞻性队列研究。在基线和12个月后测量髋部的关节间隙宽度(JSW)。以髋OA的影像学进展(JSW>0.5mm/年)为因变量(是/否),进行单变量和多变量逻辑回归分析,以评估步态期间与负荷相关的参数(即峰值髋部力矩、髋部力矩冲量和每日累积髋部力矩[髋部力矩冲量与平均每日步数的乘积])与髋OA进展之间的关联,同时对年龄、体重和最小JSW进行调整。
50例患者(47.4±10.7岁)中,21例(42.0%)被归入进展组。基线时额面较高的每日累积髋部力矩与髋OA的影像学进展在统计学上显著相关(调整后的比值比(OR)[95%置信区间(CI)],1.34[1.06-1.70];P=0.013)。矢状面较高的每日累积髋部力矩与髋OA进展的关联也接近显著(调整后的OR,1.80[0.99-3.26];P=0.052)。
在继发性髋OA女性患者中,较高的每日累积髋部力矩,尤其是在额面,是髋OA在12个月内影像学进展的预测指标。通过改变步态和体力活动来降低每日累积髋部力矩可能会减缓髋OA的进展。