Can gait patterns be explained by joint structure in people with and without radiographic knee osteoarthritis? Data from the IMI-APPROACH cohort
Skeletal Radiology, vol. 53, pp. 2409–2416
Abstract
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 (R2 = 0.24); in ROA patients, increased BMI, radiographic osteophytes, MRI meniscal extrusion and female sex showed significantly worse lower leg gait (R2 = 0.18). Higher BMI was significantly associated with reduced upper leg function for non-ROA patients (R2 = 0.05); ROA patients with male sex, higher BMI and less MRI synovitis showed significantly worse upper leg gait (R2 = 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.
Authors 10
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Mylène P. Jansen corresponding
University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, HP G02.228 Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands. m.p.jansen-36@umcutrecht.nl
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, HP G02.228 Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
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Affiliation as printed
Dynamic Metrics Limited, Codicote, UK
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University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, HP G02.228 Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
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M. Kloppenburg Aachen Clinical Epidemiology Department of Rheumatology, Leiden University Medical Center
Leiden University Medical Center
Affiliation as printed
Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
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Universidade da Coruña · Complexo Hospitalario Universitario A Coruña · Servicio Gallego de Salud · Instituto de Investigación Biomédica de A Coruña
Affiliation as printed
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
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
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Affiliation as printed
Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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Inserm · Sorbonne Université · Assistance Publique – Hôpitaux de Paris · Hôpital Saint-Antoine
Affiliation as printed
Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France
INSERM, Sorbonne University, Paris, France
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Paracelsus Medical University · Chondrometrics (Germany)
Affiliation as printed
Chondrometrics GmbH, Freilassing, Germany
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
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Boston University · Friedrich-Alexander-Universität Erlangen-Nürnberg · Universitätsklinikum Erlangen
Affiliation as printed
Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
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Paracelsus Medical University · Chondrometrics (Germany)
Affiliation as printed
Chondrometrics GmbH, Freilassing, Germany
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
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