Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA.
Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA.
PM R. 2021 Feb;13(2):128-136. doi: 10.1002/pmrj.12398. Epub 2020 May 28.
Osteoarthritis (OA) is a degenerative joint disease. Understanding contributing factors to slowing or stopping disease progression is crucial. There has been no research describing lower extremity kinematics of the hip, knee, and ankle during stair ambulation in individuals with hip OA.
To explore the differences in lower extremity kinematics between participants with clinical and morphological findings of hip OA and controls.
A cross-sectional study.
Clinical research laboratory.
Participants with radiographic and symptomatic signs of hip OA (n = 42) and healthy controls (n = 30) were enrolled.
Participants underwent hip magnetic resonance imaging (MRI). The Scoring Hip Osteoarthritis with MRI (SHOMRI) method was used to assess cartilage abnormalities. Self-reported measures of hip pain and function were obtained using the Hip Disability and Osteoarthritis Outcome Score (HOOS). Participants were assigned into a symptomatic hip osteoarthritis group (HOA) with SHOMRI>0 and HOOS≤80, and a control group (CG) with SHOMRI = 0 and HOOS>90. Patients underwent 3D motion analysis during stair ascent/descent at self-selected speed.
The primary outcome measurements were peak hip, knee, and ankle kinematics. General Estimation Equations were used to compare kinematics between groups (P ≤ .05).
The HOA group ascended stairs with a more internally rotated hip (CG = 1.77 ± 6.3; HOA = 4.97 ± 4.2; P = .02), more abducted hip (CG = -5 ± 2.7, HOA = -3.5 ± 3; P = .02), and a more externally rotated knee (CG = -8.02 ± 3; HOA = -10.63 ± 6.3; P = .02) and ankle (CG = -11.8 ± 6.1; HOA = -16.3 ± 5.6; P = .01). Similarly, HOA participants descended stairs with a more extended knee (CG = -15.5 ± 4.9; HOA = -12 ± 4.9; P = .01), and more externally rotated knee (CG = -10.1 ± 4.4; HOA = -13.1 ± 6.6; P = .04) and ankle (CG = -13.5 ± 5.3; HOA = -17.9 ± 5.5; P = .002).
Participants with hip OA-related morphology and symptoms ambulate stairs utilizing abnormal lower extremity mechanics.
骨关节炎（OA）是一种退行性关节疾病。了解减缓或阻止疾病进展的因素至关重要。目前还没有研究描述过髋关节炎患者在上下楼梯时髋关节、膝关节和踝关节的下肢运动学。
探讨有临床和形态学髋关节 OA 表现的参与者与对照组之间下肢运动学的差异。
横断面研究。
临床研究实验室。
招募了有影像学和症状性髋关节炎（n=42）和健康对照组（n=30）的参与者。
参与者接受髋关节磁共振成像（MRI）检查。使用 Scoring Hip Osteoarthritis with MRI（SHOMRI）方法评估软骨异常。使用髋关节残疾和骨关节炎结果评分（HOOS）评估髋关节疼痛和功能的自我报告测量。根据 SHOMRI>0 和 HOOS≤80 将参与者分为有症状性髋关节炎组（HOA），根据 SHOMRI=0 和 HOOS>90 将参与者分为对照组（CG）。患者以自我选择的速度进行上下楼梯时进行 3D 运动分析。
主要观察指标为髋关节、膝关节和踝关节的峰值运动学。使用广义估计方程比较组间运动学（P≤.05）。
HOA 组上楼梯时髋关节内旋更多（CG=1.77±6.3；HOA=4.97±4.2；P=.02），髋关节外展更多（CG=-5±2.7，HOA=-3.5±3；P=.02），膝关节外旋更多（CG=-8.02±3；HOA=-10.63±6.3；P=.02）和踝关节外旋更多（CG=-11.8±6.1；HOA=-16.3±5.6；P=.01）。同样，HOA 参与者下楼梯时膝关节伸展更多（CG=-15.5±4.9；HOA=-12±4.9；P=.01），膝关节外旋更多（CG=-10.1±4.4；HOA=-13.1±6.6；P=.04）和踝关节外旋更多（CG=-13.5±5.3；HOA=-17.9±5.5；P=.002）。
有髋关节 OA 相关形态和症状的参与者在上下楼梯时采用异常的下肢力学。
