Kumar Deepak, Wyatt Cory, Lee Sonia, Okazaki Narihiro, Chiba Ko, Link Thomas M, Souza Richard B, Majumdar Sharmila
Physical Therapy & Athletic Training, Boston University, 635 Commonwealth Ave, Room 524B, Boston, Massachusetts, 02215.
Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon.
J Orthop Res. 2018 May;36(5):1472-1477. doi: 10.1002/jor.23763. Epub 2017 Nov 2.
The purpose was to evaluate the association of sagittal plane gait mechanics with MRI changes in the hip joint over 18-months. Subjects with and without radiographic hip OA (n = 57) underwent MRI at baseline and 18 months for grading of cartilage lesions, bone marrow lesions (BML), cysts, and labral tears. 3D gait analyses at baseline were used for sagittal plane hip kinematics and kinetics during the stance phase. Subjects were classified as progressors or non-progressors based on increase in any MRI OA parameter. Multivariate ANOVA were used for differences in sagittal gait parameters between progressors and non-progressors at baseline while adjusting for age. Logistic regression was used to estimate the probability of being classified as a progressor or non-progressor with increasing hip flexion while adjusting for age, BMI, sex, and presence of radiographic hip OA. Of the 57, 35 were classified as non-progressors and 22 were classified as progressors. At baseline, the progressors walked with 4.5° greater hip flexion during early stance (p = 0.021) and 3.5° lesser hip extension in late stance that was nearly significant (p = 0.059). Walking with greater hip flexion at baseline was associated with a greater risk of increase in MRI defined structural changes in the hip joint (Odds Ratio = 1.1, p = 0.038). Greater hip flexion during walking was associated with a risk of structural progression of hip OA. The results may guide future interventions to alter the walking patterns and slow structural hip OA progression.© 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1472-1477, 2018.
目的是评估矢状面步态力学与髋关节在18个月内MRI变化之间的关联。有和没有影像学髋关节骨关节炎（n = 57）的受试者在基线和18个月时接受MRI检查，以对软骨损伤、骨髓损伤（BML）、囊肿和盂唇撕裂进行分级。基线时的三维步态分析用于站立期矢状面髋关节运动学和动力学分析。根据任何MRI骨关节炎参数的增加，将受试者分为进展者或非进展者。在调整年龄的同时，使用多变量方差分析比较进展者和非进展者在基线时矢状面步态参数的差异。使用逻辑回归估计在调整年龄、体重指数、性别和影像学髋关节骨关节炎存在情况后，随着髋关节屈曲增加被分类为进展者或非进展者的概率。在57名受试者中，35名被分类为非进展者，22名被分类为进展者。在基线时，进展者在早期站立时髋关节屈曲角度大4.5°（p = 0.021），在晚期站立时髋关节伸展角度小3.5°，接近显著水平（p = 0.059）。基线时髋关节屈曲角度较大与髋关节MRI定义的结构变化增加的风险较高相关（优势比 = 1.1，p = 0.038）。行走时髋关节屈曲角度较大与髋关节骨关节炎结构进展的风险相关。这些结果可能为未来改变行走模式和减缓髋关节骨关节炎结构进展的干预措施提供指导。© 2017骨科研究协会。由威利期刊公司出版。《矫形外科学研究》36:1472 - 1477，2018年。
