Are biomechanics during gait associated with the structural disease onset and progression of lower limb osteoarthritis? A systematic review and meta-analysis,Osteoarthritis and Cartilage

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Are biomechanics during gait associated with the structural disease onset and progression of lower limb osteoarthritis? A systematic review and meta-analysis
Osteoarthritis and Cartilage ( IF 7.2 ) Pub Date : 2021-10-29 , DOI: 10.1016/j.joca.2021.10.010
N D'Souza ₁ , J Charlton ₂ , J Grayson ₁ , S Kobayashi ₁ , L Hutchison ₁ , M Hunt ₃ , M Simic ₁

Affiliation

Objective

To evaluate if gait biomechanics are associated with increased risk of structurally diagnosed disease onset or progression of lower limb osteoarthritis (OA).

Method

A systematic review of Medline and Embase was conducted from inception to July 2021. Two reviewers independently screened records, extracted data and assessed risk of bias. Included studies reported gait biomechanics at baseline, and either structural imaging or joint replacement occurrence in the lower limb at follow-up. The primary outcome was the Odds Ratio (OR) (95% confidence interval (CI)) of the association between biomechanics and structural OA outcomes with data pooled for meta-analysis.

Results

Twenty-three studies reporting 25 different biomechanical metrics and 11 OA imaging outcomes were included (quality scores ranged 12–20/21). Twenty studies investigated knee OA progression; three studies investigated knee OA onset. Two studies investigated hip OA progression. 91% of studies reported a significant association between at least one biomechanical variable and OA onset or progression. There was an association between frontal plane biomechanics with medial tibiofemoral and hip OA progression and sagittal plane biomechanics with patellofemoral OA progression. Meta-analyses demonstrated increased odds of medial tibiofemoral OA progression with greater baseline peak knee adduction moment (KAM) (OR: 1.88 [95%CI: 1.08, 3.29]) and varus thrust presence (OR: 1.97 [95%CI: 1.32, 2.96]).

Conclusion

Evidence suggests that certain gait biomechanics are associated with an increased odds of OA onset and progression in the knee, and progression in the hip.

Registration number

PROSPERO CRD42019133920

中文翻译：

步态过程中的生物力学是否与下肢骨关节炎的结构性疾病发作和进展有关？系统评价和荟萃分析

客观的

评估步态生物力学是否与结构诊断疾病发作或下肢骨关节炎 (OA) 进展的风险增加有关。

方法

从成立到 2021 年 7 月，对 Medline 和 Embase 进行了系统审查。两名审查员独立筛选记录、提取数据并评估偏倚风险。纳入的研究报告了基线时的步态生物力学，以及随访时下肢结构成像或关节置换的发生。主要结果是生物力学和结构性 OA 结果之间关联的优势比 (OR) (95% 置信区间 (CI))，汇总数据用于荟萃分析。

结果

包括 23 项研究报告 25 种不同的生物力学指标和 11 种 OA 成像结果（质量评分范围为 12-20/21）。20 项研究调查了膝关节 OA 的进展；三项研究调查了膝关节 OA 的发病情况。两项研究调查了髋关节 OA 的进展。91% 的研究报告了至少一个生物力学变量与 OA 发病或进展之间的显着关联。额平面生物力学与内侧胫股骨和髋关节 OA 进展以及矢状面生物力学与髌股骨 OA 进展之间存在关联。Meta 分析表明，随着基线峰值膝关节内收力矩 (KAM) (OR: 1.88 [95%CI: 1.08, 3.29]) 和内翻推力存在 (OR: 1.97 [95%CI: 1.32, 2.96]）。