title: Asymptomatic radiographic hip osteoarthritis is associated with gait differences, especially in women: A population-based study.
abstract: Hip and knee osteoarthritis (OA) are debilitating diseases that impair gait at severe stages. Although associations between OA and gait are established for normal walking, little is known about its relation with turning and tandem (heel-to-toe) walking. Furthermore, it is unknown how asymptomatic OA associates with gait, and whether associations differ by sex. We investigated how symptomatic and asymptomatic hip and knee OA associate with gait in community-dwelling individuals.
  
  
  
  In 2706 participants of a population-based cohort study, gait was assessed by electronic walkway and summarised into seven gait domains. Hip and knee radiographs were graded for radiographic OA (ROA) using the Kellgren and Lawrence (K&L) score. Linear regression was used to investigate associations between ROA and gait. Analyses were repeated including only participants with asymptomatic ROA, defined as a K&L-score of 2 without pain.
  
  
  
  In total, 177 participants (6.5%) had hip ROA and 441 (16.3%) knee ROA. We found no associations of knee ROA with gait. Hip ROA associated with Rhythm, Tandem, and Turning. Furthermore, unilateral hip ROA associated with larger gait asymmetry and gait differences in osteoarthritic and non-osteoarthritic leg, when compared to people without hip ROA. Associations between hip ROA and gait were generally stronger for women than men. Associations for hip ROA remained after restricting to asymptomatic ROA.
  
  
  
  Hip ROA, but not knee ROA, associates with gait differences in normal walking, turning, and tandem walking in community-dwelling individuals. These associations differ between the sexes, and are already present for asymptomatic ROA.
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
authors.forename: Vincentius J A
authors.initials: VJA
authors.lastname: Verlinden
authors.affiliation: Department of Internal Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: de Kruijf
authors.affiliation: Department of General Practice, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
authors.forename: Sita M A
authors.initials: SMA
authors.lastname: Bierma-Zeinstra
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass., USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
authors.forename: André G
authors.initials: AG
authors.lastname: Uitterlinden
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands. Electronic address: m.a.ikram@erasmusmc.nl.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Department of Internal Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
authors.forename: Joyce B J
authors.initials: JBJ
authors.lastname: van Meurs
authors.affiliation: Department of Neuroscience, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jos N
authors.initials: JN
authors.lastname: van der Geest
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000503:physiopathology*; D011446:Prospective Studies; D012737:Sex Factors; D016138:Walking / Q000502:physiology*
keywords: Epidemiology; Gait; Hip osteoarthritis; Knee osteoarthritis; Sex