Individuals with mild-to-moderate hip osteoarthritis have lower limb muscle strength and volume deficits

Abstract

BackgroundIndividuals with advanced hip osteoarthritis (OA) exhibit generalized muscle weakness of the affected limb and so clinical practice guidelines recommend strength training for the management of hip OA. However, the extent and pattern of muscle weakness, including any between-limb asymmetries, in early stages of the disease are unclear. This study compared hip and knee muscle strength and volumes between individuals with mild-to-moderate symptomatic and radiographic hip OA and a healthy control group.MethodsNineteen individuals with mild-to-moderate symptomatic and radiographic hip OA (n = 12 unilateral; n = 7 bilateral) and 23 age-matched, healthy controls without radiographic hip OA or hip pain participated. Isometric strength of the hip and knee flexors and extensors, and hip abductors and adductors were measured. Hip and thigh muscle volumes were measured from lower limb magnetic resonance images. A full-factorial, two-way General Linear Model was used to assess differences between groups and between limbs.ResultsParticipants in the hip OA group demonstrated significantly lower knee flexor, knee extensor, hip flexor, hip extensor and hip abductor strength compared to controls and had significantly lower volume of the adductor, hamstring and quadriceps groups, and gluteus maximus and gluteus minimus muscles, but not tensor fasciae latae or gluteus medius muscles. There were no between-limb strength differences or volume differences within either group.ConclusionsAtrophic, bilateral hip and knee muscle weakness is a feature of individuals with mild-to-moderate hip OA. Early interventions to target muscle weakness and prevent the development of strength asymmetries that are characteristic of advanced hip OA appear warranted.

Association between hip muscle cross-sectional area and hip pain and function in individuals with mild-to-moderate hip osteoarthritis: a cross-sectional study

“…However, there were consistent data for lower hip abductor strength in people with hip OA compared with healthy controls (9,10,(22)(23)(24)30). Adding to the literature, our study found beneficial associations of larger CSA of hip adductors with better function and quality of life in hip OA.…”

“…Previous studies reported lower volume and CSA of hip adductor muscles and decreased hip adductor strength in people with hip OA compared with healthy controls (10,22) Other studies investigating pain and injury reported a lower hip adduction/abduction strength ratio in soccer players with groin pain compared with those without groin pain (15) and that hip adductor strength was decreased both preceding and during the onset of groin pain in football players (16). Although these studies investigated adductor strength rather than CSA, the findings indicate the importance of hip adductor muscles when considering pain and recovery for better function.…”

“…There is evidence for generalized muscle weakness of the affected leg in people with unilateral hip OA, due to multifactorial mechanisms including a combination of reduced muscle size (atrophy), muscle inhibition, and decreased muscle quality (9). More specifically, there is evidence of deficits in lower limb muscle strength and size in people with mild-to-moderate hip OA relative to healthy controls (10,11), and biomechanical studies reported functional deficits during walking and sit-to-stand in participants with mild-to-moderate hip OA compared with healthy controls (12,13) and altered muscle activity during gait in people with hip OA compared with healthy controls (14). However, there are limited data examining the associations between hip muscle properties and patient-reported outcomes in pain and function.…”

Does low back pain or leg pain in gluteus medius syndrome contribute to lumbar degenerative disease and hip osteoarthritis and vice versa? A literature review

“…Cases References to GMedS Loureiro A et al 129) Patients with symptomatic hip OA (n=19) Hip abd. strength was significantly decreased compared with controls GMed volume was not significantly decreased compared with controls Zacharias A et al 130) Patients with unilateral Hip OA (n=20)…”

Diagnose Arthrose

“…Die Beobachtung zeigt sich kon sistent in weiteren Studien. Aktuell ist eine verminderte Muskel dichte und -Atrophie auch bei Patienten mit milder Coxarthrose gezeigt worden [35]. Aus diesen Beobachtungen ergibt sich, dass die muskuläre Beeinträchtigung am Beginn der Erkrankung steht und nicht die Folge der etablierten Arthrose ist.…”