Summary
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
Keywords
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Article info
Publication history
Published online: October 28, 2021
Accepted:
October 23,
2021
Received:
May 9,
2021
Identification
Copyright
© 2021 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
