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Journal Article Ppublish 7 citations

PubMed: 38536417 DOI: 10.1007/s00256-024-04666-8

Can gait patterns be explained by joint structure in people with and without radiographic knee osteoarthritis? Data from the IMI-APPROACH cohort.

Skeletal Radiol 53(11):2409-2416

Authors: M P Jansen, D Hodgins, S C Mastbergen, M Kloppenburg, F J Blanco, I K Haugen, F Berenbaum, F Eckstein, F W Roemer, W Wirth

Affiliations

  • Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, HP G02.228 Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands.
  • Dynamic Metrics Limited, Codicote, UK.
  • Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, HP G02.228 Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands.
  • Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
  • Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
  • Departamento de Fisioterapia Y Medicina, Grupo de Investigación de Reumatología (GIR), INIBIC - Complejo Hospitalario Universitario de A Coruña, SERGAS. Centro de Investigación CICA, Universidad de A Coruña, A Coruña, Spain. Servicio de Reumatologia, INIBIC- Universidade de A Coruña, A Coruña, Spain.
  • Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
  • Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France.
  • INSERM, Sorbonne University, Paris, France.
  • Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria.
  • Chondrometrics GmbH, Freilassing, Germany.
  • Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
  • Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.

Abstract

OBJECTIVE

To determine the association between joint structure and gait in patients with knee osteoarthritis (OA).

METHODS

IMI-APPROACH recruited 297 clinical knee OA patients. Gait data was collected (GaitSmart®) and OA-related joint measures determined from knee radiographs (KIDA) and MRIs (qMRI/MOAKS). Patients were divided into those with/without radiographic OA (ROA). Principal component analyses (PCA) were performed on gait parameters; linear regression models were used to evaluate whether image-based structural and demographic parameters were associated with gait principal components.

RESULTS

Two hundred seventy-one patients (age median 68.0, BMI 27.0, 77% female) could be analyzed; 149 (55%) had ROA. PCA identified two components: upper leg (primarily walking speed, stride duration, hip range of motion [ROM], thigh ROM) and lower leg (calf ROM, knee ROM in swing and stance phases). Increased age, BMI, and radiographic subchondral bone density (sclerosis), decreased radiographic varus angle deviation, and female sex were statistically significantly associated with worse lower leg gait (i.e. reduced ROM) in patients without ROA (R = 0.24); in ROA patients, increased BMI, radiographic osteophytes, MRI meniscal extrusion and female sex showed significantly worse lower leg gait (R = 0.18). Higher BMI was significantly associated with reduced upper leg function for non-ROA patients (R = 0.05); ROA patients with male sex, higher BMI and less MRI synovitis showed significantly worse upper leg gait (R = 0.12).

CONCLUSION

Structural OA pathology was significantly associated with gait in patients with clinical knee OA, though BMI may be more important. While associations were not strong, these results provide a significant association between OA symptoms (gait) and joint structure.

MeSH

Osteoarthritis, Knee, Osteoarthritis, Gait, Radiography, Sex

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