Restriction In Hip Internal Rotation During Stance Phase In An Early Stage Of Hip Osteoarthritis

Abstract

Most studies of gait analysis in hip osteoarthritis (OA) have involved patients with end-stage hip osteoarthritis or after total hip replacement. However, there have been few studies of patients with early stage of hip OA is few investigation. PURPOSE: The purpose of this study was to analyse of gait pattern in the hip joint during stance phase, in patients with early stage of hip OA. METHODS: Data of gait analysis was obtained from medical records of patients. Patients with early stages of hip OA (without acetabular dysplasia [sharp angle 41.9 ± 4.59 deg.], n=22, female, age: 55.4 ± 7.962 [44~70] yrs, height: 156.7 ± 5.14 cm, weight: 51.5 ± 6.75 kg [Hip OA]) and patients with traumatic temporomandibular disorder after a road traffic accident without lower extremity and lower back disorder (n=20, female, age: 51.9 ± 7.95 [40~66] yrs, height: 160.0 ± 5.86 cm, weight: 54.0 ± 8.76 kg [C]) between 2014 and 2019. Two-way ANOVA was used for statistical analysis between group [Hip OA-C] and within subject [side]. RESULTS: Results (mean ± SD) of range (degree) of hip extension to flexion during gait cycle were C 48.0 ± 6.63 and Hip OA 45.3 ± 8.29 (p > .05). Range of hip adduction of Hip OA was significantly smaller than C (F = 4.72, p < .05, ES f = 0.438). Results of range of hip adduction during early stance phase were C 9.1 ± 3.44 and Hip OA 7.2 ± 2.44. Range of hip adduction of Hip OA was significantly smaller than C (F = 4.72, p < .05, ES f = 0.438). Results of range of hip internal rotation during early stance phase were small side C 9.7±3.75, large side C 11.6±3.71, affected side Hip OA 7.50 ± 3.84 and unaffected side Hip OA 11.2 ± 3.62. Results of range of hip internal rotation were observed interaction (F=8.90, p<.01, ES f = 0.472). Unaffected side Hip OA was significantly smaller than unaffected side (F = 80.39, p<.001, ES f = 1.418) and small side of C (F = 3.26, adjusted p < 15, ES f = 0.285). CONCLUSIONS: In patients with early stage of hip OA, hip extension during gait wasn’t restricted, but hip adduction and hip internal rotation during early stance phase of gait were restricted. This hip joint restriction may be influenced by degeneration of ligamentum teres femoris which carries blood supply of femur head. Rotation restriction during stance phase by weight-bearing in early phase of hip OA occurs before hip joint extension restriction.