Determination of Leg Alignment in Hip Osteoarthritis Patients with the EOS® System and the Effect on External Joint Moments during Gait

Stefan Van Drongelen,Ayman Assi,Hanna Kaldowski,Felix Stief,Andrea Meurer,Benjamin Fey,Timur Tarhan

doi:10.3390/app10217777

Abstract

The present study considered the entire leg alignment and links static parameters to the external joint moments during gait in patients with hip osteoarthritis. Eighteen patients with unilateral hip osteoarthritis were measured using the EOS® system. Clinical leg alignment and femoral parameters were extracted from the 3D reconstruction of the EOS images. A 3D gait analysis was performed and external knee and hip adduction moments were computed and compared to 18 healthy controls in the same age group. The knee adduction moments of the involved leg were strongly correlated to the femoral offset and the varus/valgus alignment. These parameters alone explained over 50% of the variance in the knee adduction moments. Adding the pelvic drop of the contralateral side increased the model of femoral offset and varus/valgus alignment and explained 78% of the knee adduction moment during the first half of the stance phase. The hip adduction moments were best associated with the hip kinematics and not the leg alignment.

Highlights

Hip osteoarthritis (OA) is a frequent musculoskeletal degenerative disease [1], initially causing pain during movement, which progresses on to include pain at rest
The goal of this study was (1) to test whether there were differences in clinical leg parameters measured with the EOS system between the involved and non-involved side of unilateral hip OA patients and a healthy control group, (2) to confirm that patients with unilateral hip OA showed a deviating gait pattern to healthy controls walking at a similar walking speed, (3) to test whether the clinical leg parameters measured using the EOS system correlated with external joint moment alterations during gait in unilateral hip OA patients, and (4) to test whether the external joint moment alterations were best associated to a combination of clinical leg parameters and gait kinematics
Than et al [34] found a reduced neck–shaft angle (NSA) in their hip OA patients compared to the healthy controls and suggested that it might be due to the younger age of the healthy controls, as the NSA decreased over time

Summary

Introduction

Hip osteoarthritis (OA) is a frequent musculoskeletal degenerative disease [1], initially causing pain during movement, which progresses on to include pain at rest. While the mechanism of the development of hip OA is not fully understood, some studies claim that anatomical deviations, especially of the acetabulum and the geometric relation between the head and the shaft, may play a role in the initiation and the course of hip OA [2,3]. In hip OA patients, Bendaya et al [4] reported changes in leg alignment with a significantly higher sacral slope and a higher femoral mechanical angle. More studies have already reported on the causal relationship between leg alignment and knee OA. A varus alignment of the knee seems to worsen OA in the medial compartment, whereas a valgus.

Objectives

Methods

Results

Discussion

Conclusion