Abstract
Asymmetry during gait is associated with the evolution of secondary osteoarthritis. Kinematic asymmetry has been reported in advanced stages of hip osteoarthritis but has not been evaluated in earlier stages of the disease or has it been directly compared with unilateral and bilateral hip osteoarthritis. Our objective was to evaluate within-group symmetry and compare between-group asymmetry for three-dimensional pelvis, hip, knee, and ankle kinematics during walking and sit-to-stand in individuals with unilateral mild-to-moderate hip OA, bilateral mild-to-moderate hip osteoarthritis, and healthy controls. Twelve individuals with unilateral mild-to-moderate hip OA, nine individuals with bilateral mild-to-moderate symptomatic and radiographic hip OA, and 21 age-comparable healthy controls underwent three-dimensional motion analysis during walking and sit-to-stand. Pelvis and lower limb joint angles were calculated using inverse kinematics and between-limb symmetry was assessed for each group. Any resulting asymmetries (most affected minus contralateral limb) were compared between groups. Participants with unilateral hip osteoarthritis exhibited significantly less hip extension (7.90°), knee flexion (4.72°), and anterior pelvic tilt (3.38°) on their affected limb compared with the contralateral limb during the stance phase of walking. Those with unilateral hip osteoarthritis were significantly more asymmetrical than controls for sagittal plane hip and pelvis angles. No significant asymmetries were detected within- or between-groups for sit-to-stand. Individuals with unilateral hip osteoarthritis exhibited lower limb asymmetries consistent with those reported in advanced stages of disease during walking, but not sit-to-stand. Consideration of the possible negative effects of gait asymmetry on the health of the affected and other compensating joints appears warranted in the management of hip OA.
Highlights
Hip osteoarthritis (OA) is a prevalent degenerative joint disease causing pain, disability, and reduced quality of life [1]
Lower limb biomechanics are altered during activities of daily living in people with advanced hip OA compared with healthy controls [4] and remain altered following total hip replacement (THR) [5,6]
The unilateral hip OA and bilateral hip OA groups had significantly smaller JSW on the index limb compared with controls; the bilateral hip OA group had significantly smaller JSW on the non-index limb compared with controls
Summary
Hip osteoarthritis (OA) is a prevalent degenerative joint disease causing pain, disability, and reduced quality of life [1]. In the case of lower limb OA, altered biomechanical patterns in the lower extremity appear to reflect a motor control strategy intended to reduce symptoms and compensate for neuromuscular deficits including muscle weakness on the affected limb, and have the potential to contribute to ongoing disease progression by altering biomechanical patterns in the affected joint. While there is evidence for kinematic asymmetry during walking and sit-to-stand in individuals with advanced unilateral hip OA [11,13,14] and following THR [6,14,15,16,17,18], the presence of kinematic asymmetry in mild-to-moderate hip OA, where there is potential to prevent or slow disease progression, has not been established
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