Wiley InterScience: Journal: Abstract

Save Article to My Profile Download Citation

Abstract | References | Full Text: HTML, PDF (112k) | Related Articles | Citation Tracking

Research Article

Hip abduction moment and protection against medial tibiofemoral osteoarthritis progression

Alison Chang¹, Karen Hayes¹, Dorothy Dunlop¹, Jing Song¹, Debra Hurwitz², September Cahue¹, Leena Sharma^{1 *}

¹Feinberg School of Medicine, Northwestern University, Chicago, Illinois
²Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois

email: Leena Sharma (L-Sharma@northwestern.edu)

^*Correspondence to Leena Sharma, Division of Rheumatology, Feinberg School of Medicine, Northwestern University, 240 East Huron, Suite 2300, Chicago, IL 60611

Funded by:
NIH; Grant Number: P60-AR-48098, R01-48748, R01-AR-46225, RR-00048

Abstract

Objective

To test the hypothesis that a greater peak internal hip abduction moment is associated with a reduced likelihood of ipsilateral medial tibiofemoral osteoarthritis (OA) progression.

Methods

Fifty-seven persons with knee OA (by definite osteophyte presence and symptoms) were evaluated. Baseline assessments included kinematic and kinetic gait parameters, obtained with an optoelectronic camera system and force platform, with inverse dynamics used to calculate 3-dimensional moments at the joints; pain, using a separate visual analog scale for each knee; and alignment, using full-limb radiographs. Radiographs of the knee in a semiflexed position, with fluoroscopic confirmation of tibial rim alignment, were obtained at baseline and 18 months later. Disease progression was defined as worsening of the grade of medial joint space narrowing. Logistic regression obtained with generalized estimating equations was used to estimate odds ratios (ORs) for progression per unit of hip abduction moment, after excluding knees with the worst joint space grade at baseline (which could not progress).

Results

The 57 participants (63% women) with mild to moderate OA had a mean age of 67 years and a mean body mass index of 29. A greater internal hip abduction moment during gait was associated with a reduced likelihood of medial tibiofemoral OA progression, with OR/unit hip abduction moment of 0.52 and a 95% confidence interval (95% CI) of 0.32-0.85. This protective effect persisted after adjustment for age, sex, walking speed, knee pain severity, physical activity, varus malalignment severity, hip OA presence, and hip OA symptom presence, with an adjusted OR of 0.43 a 95% CI of 0.22-0.81.

Conclusion

A greater hip abduction moment during gait at baseline protected against ipsilateral medial OA progression from baseline to 18 months. The likelihood of medial tibiofemoral OA progression was reduced 50% per 1 unit of hip abduction moment.

Received: 25 March 2005; Accepted: 9 August 2005

Digital Object Identifier (DOI)

10.1002/art.21406 About DOI