Degenerative Hip Osteoarthritis in Unilateral Knee Osteoarthritis Patients: A Correlation Analysis

Abstract

Objective: Hip and knee OA often occur successively. However, little is known about the relationship between hip and knee OA in unilateral knee OA patients. The aim of the study was to explore the correlation between unilateral knee OA and bilateral hip degeneration to determine the impact unilateral knee OA has on the severity of hip degeneration.

Methods: This retrospective case–control study enrolled 162 patients who were presented with unilateral knee osteoarthritis and hospitalized in Zhongshan hospital, Fudan University, from January 2016 to December 2018. The severity of affected knee joint and bilateral hip joint was evaluated by using the Kellgren–Lawrence (KL) score. Variates, such as gender, age, body mass index (BMI) and Knee Society Score (KSS) at admission, were also recorded. Differences in the severity of OA between ipsilateral, contralateral hip joints and affected knee joints were accessed with chi-square tests. Single-factor and multi-factor logistic regression were applied to determine the risk factors for hip OA in patients with unilateral knee OA.

Results: Gender have no impact on KSS, the length of disease, and BMI of patients. In contralateral hip joints, there was significant difference in the proportion of patients with severe hip degeneration (KL score ≥ 2) compared to those with mild hip degeneration (KL score < 2) when considering length of disease (p < 0.001), KSS symptom score < 70 (p = 0.001) or KSS function score (p < 0.001). The risk factors for contralateral hip degeneration of patients with unilateral knee OA include that long disease course (> 5 years) (OR 3.030 [95% CI 1.476 to 6.220]; p < 0.001), and high KSS function score (≥ 70 year) (OR 0.921 [95% CI 0.878 to 0.967]; p < 0.001), increased risk of contralateral hip degeneration of patients with unilateral knee OA.

Conclusions: The correlation between unilateral knee OA and contralateral hip degeneration was stronger than that between unilateral knee OA and ipsilateral hip degeneration. For knee OA patients with longer course and lower KSS functional score, more attention should be paid to the degeneration process of the contralateral hip joint.

Keywords

correlation / hip degeneration / knee OA / knee society score / risk factors

References

[1] J. VL and H. DJ, “The Epidemiology of Osteoarthritis. Best Practice & Research,” Clinical Rheumatology 28, no. 1 (2014): 5-15.

[2] T. Vos, A. D. Flaxman, M. Naghavi, et al., “Years Lived With Disability (YLDs) for 1160 Sequelae of 289 Diseases and Injuries 1990-2010: A Systematic Analysis for the Global Burden of Disease Study 2010,” Lancet (London, England) 380, no. 9859 (2012): 2163-2196.

[3] G. A. Hawker, “Osteoarthritis Is a Serious Disease,” Clinical and Experimental Rheumatology 37, no. Suppl 120 (2019): 3-6.

[4] D. T. Felson, A. Naimark, J. Anderson, L. Kazis, W. Castelli, and R. F. Meenan, “The Prevalence of Knee Osteoarthritis in the Elderly. The Framingham Osteoarthritis Study,” Arthritis and Rheumatism 30, no. 8 (1987): 914-918.

[5] M. C. Corti and C. Rigon, “Epidemiology of Osteoarthritis: Prevalence, Risk Factors and Functional Impact,” Aging Clinical and Experimental Research 15, no. 5 (2003): 359-363.

[6] E. C. Sayre, J. M. Jordan, J. Cibere, et al., “Quantifying the Association of Radiographic Osteoarthritis in Knee or Hip Joints With Other Knees or Hips: The Johnston County Osteoarthritis Project,” Journal of Rheumatology 37, no. 6 (2010): 1260-1265.

[7] N. Shakoor, J. A. Block, S. Shott, et al., “Nonrandom Evolution of End-Stage Osteoarthritis of the Lower Limbs,” Arthritis and Rheumatism 46, no. 12 (2002): 3185-3189.

[8] G. Filardo, E. Kon, U. G. Longo, et al., “Non-Surgical Treatments for the Management of Early Osteoarthritis,” Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA 24, no. 6 (2016): 1775-1785.

[9] W. H. Robinson, C. M. Lepus, Q. Wang, et al., “Low-Grade Inflammation as a Key Mediator of the Pathogenesis of Osteoarthritis,” Nature Reviews Rheumatology 12, no. 10 (2016): 580-592.

[10] C. Palazzo, C. Nguyen, M. M. Lefevre-Colau, et al., “Risk Factors and Burden of Osteoarthritis,” Annals of Physical and Rehabilitation Medicine 59, no. 3 (2016): 134-138.

[11] J. N. Belo, M. Y. Berger, M. Reijman, et al., “Prognostic Factors of Progression of Osteoarthritis of the Knee: A Systematic Review of Observational Studies,” Arthritis and Rheumatism 57, no. 1 (2007): 13-26.

[12] D. T. Felson, R. C. Lawrence, P. A. Dieppe, et al., “Osteoarthritis: New Insights. Part 1: The Disease and Its Risk Factors,” Annals of Internal Medicine 133, no. 8 (2000): 635-646.

[13] V. K. Srikanth, J. L. Fryer, G. Zhai, et al., “A Meta-Analysis of Sex Differences Prevalence, Incidence and Severity of Osteoarthritis,” Osteoarthritis and Cartilage 13, no. 9 (2005): 769-781.

[14] M. J. Berger, M. K. CA, D. G. Chess, et al., “Sex Differences in Quadriceps Strength in OA,” International Journal of Sports Medicine 33, no. 11 (2012): 926-933.

[15] K. Magnusson, K. Scurrah, E. Ystrom, et al., “Genetic Factors Contribute More to Hip Than Knee Surgery due to Osteoarthritis - a Population-Based Twin Registry Study of Joint Arthroplasty,” Osteoarthritis and Cartilage 25, no. 6 (2017): 878-884.

[16] K. Godziuk, C. M. Prado, L. J. Woodhouse, et al., “The Impact of Sarcopenic Obesity on Knee and Hip Osteoarthritis: A Scoping Review,” BMC Musculoskeletal Disorders 19, no. 1 (2018): 271.

[17] R. D. Altman, E. Abadie, B. Avouac, et al., “Total Joint Replacement of Hip or Knee as an Outcome Measure for Structure Modifying Trials in Osteoarthritis,” Osteoarthritis and Cartilage 13, no. 1 (2005): 13-19.

[18] K. L. Bennell, T. V. Wrigley, M. A. Hunt, et al., “Update on the Role of Muscle in the Genesis and Management of Knee Osteoarthritis,” Rheumatic Diseases Clinics of North America 39, no. 1 (2013): 145-176.

[19] J. Chon, H. S. Kim, J. H. Lee, et al., “Association Between Asymmetry in Knee Extension Strength and Balance in a Community-Dwelling Elderly Population: A Cross-Sectional Analysis,” Annals of Rehabilitation Medicine 42, no. 1 (2018): 113-119.

[20] T. D. Spector and M. G. AJ, “Risk Factors for Osteoarthritis: Genetics,” Osteoarthritis and Cartilage 12, no. 1 (2004): S39-S44.

[21] J. Zeni, F. Pozzi, S. Abujaber, et al., “Relationship Between Physical Impairments and Movement Patterns During Gait in Patients With End-Stage Hip Osteoarthritis,” Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society 33, no. 3 (2015): 382-389.

[22] M. Harris-Hayes, M. J. Mueller, S. A. Sahrmann, et al., “Persons With Chronic Hip Joint Pain Exhibit Reduced Hip Muscle Strength,” ssJournal of Orthopaedic and Sports Physical Therapy 44, no. 11 (2014): 890-898.

[23] R. J. Leigh, S. T. Osis, and R. Ferber, “Kinematic Gait Patterns and Their Relationship to Pain in Mild-To-Moderate Hip Osteoarthritis,” Clinical Bsiomechanics 34 (2016): 12-17.

[24] N. Shakoor, K. C. Foucher, M. A. Wimmer, et al., “Asymmetries and Relationships Between Dynamic Loading, Muscle Strength, and Proprioceptive Acuity at the Knees in Symptomatic Unilateral Hip Osteoarthritis,” Arthritis Research & Therapy 16, no. 6 (2014): 455.

[25] F. Pozzi, L. Snyder-Mackler, and J. Zeni, “Relationship Between Biomechanical Asymmetries During a Step Up and Over Task and Stair Climbing After Total Knee Arthroplasty,” Clinical Biomechanics 30, no. 1 (2015): 78-85.

[26] P. M. Jungmann, M. C. Nevitt, T. Baum, et al., “Relationship of Unilateral Total Hip Arthroplasty (THA) to Contralateral and Ipsilateral Knee Joint Degeneration-a Longitudinal 3T MRI Study From the Osteoarthritis Initiative (OAI),” Osteoarthritis and Cartilage 23, no. 7 (2015): 1144-1153.

[27] K. C. Foucher and M. A. Wimmer, “Contralateral Hip and Knee Gait Biomechanics Are Unchanged by Total Hip Replacement for Unilateral Hip Osteoarthritis,” Gait & Posture 35, no. 1 (2012): 61-65.

[28] S. C. Petterson, P. Barrance, T. Buchanan, et al., “Mechanisms Underlying Quadriceps Weakness in Knee Osteoarthritis,” Medicine and Science in Sports and Exercise 40, no. 3 (2008): 422-427.

[29] T. M. Griffin and F. Guilak, “The Role of Mechanical Loading in the Onset and Progression of Osteoarthritis,” Exercise and Sport Sciences Reviews 33, no. 4 (2005): 195-200.

[30] J. J. Anderson and D. T. Felson, “Factors Associated With Osteoarthritis of the Knee in the First National Health and Nutrition Examination Survey (HANES I). Evidence for an Association With Overweight, Race, and Physical Demands of Work,” American Journal of Epidemiology 128, no. 1 (1988): 179-189.

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