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Asymmetries and relationships between dynamic loading,muscle strength,and proprioceptive acuity at the knees in symptomatic unilateral hip osteoarthritis
Authors:Najia Shakoor  Kharma C Foucher  Markus A Wimmer  Rachel A Mikolaitis-Preuss  Louis F Fogg  Joel A Block
Institution:.Section of Rheumatology, Rush Medical College, Rush University, 1611 West Harrison Street, Suite 510, Chicago, IL 60612 USA ;.Department of Kinesiology and Nutrition, University of Illinois Chicago, 1200 West Harrison Street, Chicago, IL 60607 USA ;.Department of Orthopedic Surgery, Rush University, 1653 West Congress Parkway, Chicago, IL 60612 USA ;.College of Nursing, Rush University, 600 South Paulina Street, Chicago, IL 60612 USA
Abstract:

Introduction

High joint loading, knee muscle weakness, and poor proprioceptive acuity are important factors that have been linked to knee osteoarthritis (OA). We previously reported that those with unilateral hip OA and bilateral asymptomatic knees are more predisposed to develop progressive OA in the contralateral knee relative to the ipsilateral knee. In the present study, we evaluate asymmetries in muscle strength and proprioception between the limbs and also evaluate relationships between these factors and joint loading that may be associated with the asymmetric evolution of OA in this group.

Methods

Sixty-two participants with symptomatic unilateral hip OA and asymptomatic knees were evaluated for muscle strength, joint position sense and dynamic joint loads at the knees. Muscle strength and proprioception were compared between limbs and correlations between these factors and dynamic joint loading were evaluated. Subgroup analyses were also performed in only those participants that fulfilled criteria for severe hip OA.

Results

Quadriceps muscle strength was 15% greater, and in the severe subgroup, proprioceptive acuity was 25% worse at the contralateral compared to ipsilateral knee of participants with unilateral hip OA (P <0.05). In addition, at the affected limb, there was an association between decreased proprioceptive acuity and higher knee loading (Spearman’s rho = 0.377, P = 0.007) and between decreased proprioceptive acuity and decreased muscle strength (Spearman’s rho = −0.328, P = 0.016).

Conclusions

This study demonstrated asymmetries in muscle strength and proprioception between the limbs in a unilateral hip OA population. Early alterations in these factors suggest their possible role in the future development of OA at the contralateral ‘OA-predisposed knee’ in this group. Furthermore, the significant association observed between proprioception, loading, and muscle strength at the affected hip limb suggests that these factors may be interrelated.
Keywords:
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