. 2024 Nov;53(11):2409-2416.

doi: 10.1007/s00256-024-04666-8. Epub 2024 Mar 27.

Can gait patterns be explained by joint structure in people with and without radiographic knee osteoarthritis? Data from the IMI-APPROACH cohort

M P Jansen¹, D Hodgins², S C Mastbergen³, M Kloppenburg^{4

5}, F J Blanco⁶, I K Haugen⁷, F Berenbaum^{8

9}, F Eckstein^{10

11}, F W Roemer^{12

13}, W Wirth^{10

11}

Affiliations

¹ Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, HP G02.228 Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands. m.p.jansen-36@umcutrecht.nl.
² Dynamic Metrics Limited, Codicote, UK.
³ Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, HP G02.228 Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands.
⁴ Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
⁵ Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
⁶ Departamento de Fisioterapia Y Medicina, Grupo de Investigación de Reumatología (GIR), INIBIC - Complejo Hospitalario Universitario de A Coruña, SERGAS. Centro de Investigación CICA, Universidad de A Coruña, A Coruña, Spain. Servicio de Reumatologia, INIBIC- Universidade de A Coruña, A Coruña, Spain.
⁷ Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
⁸ Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France.
⁹ INSERM, Sorbonne University, Paris, France.
¹⁰ Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria.
¹¹ Chondrometrics GmbH, Freilassing, Germany.
¹² Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
¹³ Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.

PMID: 38536417
PMCID: PMC11410921
DOI: 10.1007/s00256-024-04666-8

Can gait patterns be explained by joint structure in people with and without radiographic knee osteoarthritis? Data from the IMI-APPROACH cohort

M P Jansen et al. Skeletal Radiol. 2024 Nov.

. 2024 Nov;53(11):2409-2416.

doi: 10.1007/s00256-024-04666-8. Epub 2024 Mar 27.

Authors

M P Jansen¹, D Hodgins², S C Mastbergen³, M Kloppenburg^{4

5}, F J Blanco⁶, I K Haugen⁷, F Berenbaum^{8

9}, F Eckstein^{10

11}, F W Roemer^{12

13}, W Wirth^{10

11}

Affiliations

¹ Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, HP G02.228 Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands. m.p.jansen-36@umcutrecht.nl.
² Dynamic Metrics Limited, Codicote, UK.
³ Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, HP G02.228 Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands.
⁴ Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
⁵ Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
⁶ Departamento de Fisioterapia Y Medicina, Grupo de Investigación de Reumatología (GIR), INIBIC - Complejo Hospitalario Universitario de A Coruña, SERGAS. Centro de Investigación CICA, Universidad de A Coruña, A Coruña, Spain. Servicio de Reumatologia, INIBIC- Universidade de A Coruña, A Coruña, Spain.
⁷ Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
⁸ Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France.
⁹ INSERM, Sorbonne University, Paris, France.
¹⁰ Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria.
¹¹ Chondrometrics GmbH, Freilassing, Germany.
¹² Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
¹³ Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.

PMID: 38536417
PMCID: PMC11410921
DOI: 10.1007/s00256-024-04666-8

Abstract

Objective: To determine the association between joint structure and gait in patients with knee osteoarthritis (OA).

Methods: IMI-APPROACH recruited 297 clinical knee OA patients. Gait data was collected (GaitSmart®) and OA-related joint measures determined from knee radiographs (KIDA) and MRIs (qMRI/MOAKS). Patients were divided into those with/without radiographic OA (ROA). Principal component analyses (PCA) were performed on gait parameters; linear regression models were used to evaluate whether image-based structural and demographic parameters were associated with gait principal components.

Results: Two hundred seventy-one patients (age median 68.0, BMI 27.0, 77% female) could be analyzed; 149 (55%) had ROA. PCA identified two components: upper leg (primarily walking speed, stride duration, hip range of motion [ROM], thigh ROM) and lower leg (calf ROM, knee ROM in swing and stance phases). Increased age, BMI, and radiographic subchondral bone density (sclerosis), decreased radiographic varus angle deviation, and female sex were statistically significantly associated with worse lower leg gait (i.e. reduced ROM) in patients without ROA (R² = 0.24); in ROA patients, increased BMI, radiographic osteophytes, MRI meniscal extrusion and female sex showed significantly worse lower leg gait (R² = 0.18). Higher BMI was significantly associated with reduced upper leg function for non-ROA patients (R² = 0.05); ROA patients with male sex, higher BMI and less MRI synovitis showed significantly worse upper leg gait (R² = 0.12).

Conclusion: Structural OA pathology was significantly associated with gait in patients with clinical knee OA, though BMI may be more important. While associations were not strong, these results provide a significant association between OA symptoms (gait) and joint structure.

Keywords: Gait; Osteoarthritis; Pathology; ROM; Structure.

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Conflict of interest statement

DH: founder and CEO of Dynamic Metrics Ltd, owner of GaitSmart. MK: consulting fees from Abbvie, Pfizer, Kiniksa, Flexion, Galapagos, Jansen, CHDR, Novartis, UCB, all paid to institution. FJB: funding from Gedeon Richter Plc., Bristol-Myers Squibb International Corporation (BMSIC), Sun Pharma Global FZE, Celgene Corporation, Janssen Cilag International N.V, Janssen Research & Development, Viela Bio, Inc., Astrazeneca AB, UCB BIOSCIENCES GMBH, UCB BIOPHARMA SPRL, AbbVie Deutschland GmbH & Co.KG, Merck KGaA, Amgen, Inc., Novartis Farmacéutica, S.A., Boehringer Ingelheim España, S.A, CSL Behring, LLC, Glaxosmithkline Research & Development Limited, Pfizer Inc, Lilly S.A., Corbus Pharmaceuticals Inc., Biohope Scientific Solutions for Human Health S.L., Centrexion Therapeutics Corp., Sanofi, TEDEC-MEIJI FARMA S.A., KiniksaPharmaceuticals, Ltd. Grunenthal. IKH: Research grant (ADVANCE) from Pfizer (payment to institution) and consulting fees from Novartis, Grünenthal and GSK, outside of the submitted work. FB: Institutional grants from TRB Chemedica and Pfizer. Consulting fees from AstraZeneca, Boehringer Ingelheim, Heel, Galapagos, Gilead, Grunenthal, GSK, Eli Lilly, MerckSerono, MSD, Nordic Bioscience, Novartis, Pfizer, Roche, Sandoz, Sanofi, Servier, UCB, 4P Pharma. Honoraria for lectures from Pfizer, Eli Lilly, Viatris. Payment for expert testimony from Pfizer and Eli Lilly. Travel support from Nordic Pharma, Pfizer, Eli Lilly, Novartis. Stock owner and CMO of 4Moving Biotech. FE: CEO and shareholder of Chondrometrics GmbH, received personal fees from TrialSpark, 4P Pharma, Norvartis, Servier, Galapagos and Merck and grants from PMU, BMBF, EU, NIH, FNIH, Merck, Galapagos NV, Novartis, TissueGene, CALIBR, ICM, Bioclinica/Clario, Universities of Erlangen Sydney, Basel Western Ontario, Stanford and Utrecht. FWR: shareholder of Boston Imaging Core Lab (BICL), LLC and consultant to Calibr and Grünenthal. WW: Employee and shareholder of Chondrometrics GmbH and consulting fees from Galapagos NV. The other authors have nothing to disclose.

Figures

**Fig. 1**
Example of GaitSmart system in use

See this image and copyright information in PMC

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Can gait patterns be explained by joint structure in people with and without radiographic knee osteoarthritis? Data from the IMI-APPROACH cohort

Affiliations

Can gait patterns be explained by joint structure in people with and without radiographic knee osteoarthritis? Data from the IMI-APPROACH cohort

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