Impact of repeated measures of joint space width on the sample size calculation: An application to hip osteoarthritis

Abstract Background: Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed.Methods: Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moments changes during gait were compared between types.Results: The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC.Conclusions: Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA.

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Validity and responsiveness of radiographic joint space width metric measurement in hip osteoarthritis: a systematic review

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2010.12.014 ◽

2011 ◽

Vol 19 (5) ◽

pp. 543-549 ◽

Cited By ~ 22

Author(s):

D. Chu Miow Lin ◽

W.M. Reichmann ◽

L. Gossec ◽

E. Losina ◽

P.G. Conaghan ◽

...

Keyword(s):

Systematic Review ◽

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Metric Measurement ◽

Space Width

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Associations between baseline and longitudinal semi‐automated quantitative joint space width at the hip and incident hip osteoarthritis: Data from a community‐based cohort

Arthritis Care & Research ◽

10.1002/acr.24742 ◽

2021 ◽

Author(s):

Amanda E. Nelson ◽

Jacquelyn A. Smith ◽

Carolina Alvarez ◽

Liubov Arbeeva ◽

Jordan B. Renner ◽

...

Keyword(s):

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Community Based ◽

Space Width

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Short-term changes in radiographic joint space width after jiggling exercise as conservative treatment for hip osteoarthritis: A retrospective case series of nine patients

PLoS ONE ◽

10.1371/journal.pone.0253643 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253643

Author(s):

Hisayoshi Yoshizuka ◽

Takanori Sato ◽

Junya Murakami ◽

Tsubasa Mitsutake ◽

Masao Hiromatsu

Keyword(s):

Conservative Treatment ◽

Weight Bearing ◽

Joint Space Width ◽

Case Series ◽

Hip Osteoarthritis ◽

Joint Space ◽

Post Discharge ◽

Retrospective Case ◽

Terminal Stage ◽

Space Width

Jiggling exercise is a conservative treatment for hip osteoarthritis, which involves continuous shaking of the foot and leg in small oscillations while seated. Previous studies have shown beneficial effects of jiggling exercises for outpatients with advanced- and terminal-stage hip osteoarthritis when performed for longer than 1 year, including increases in joint space width and remission of symptoms. We aimed to use the data from our own treatment to evaluate the short-term impact of intensive jiggling exercises on inpatients with hip osteoarthritis to further examine the clinical utility of this exercise. This retrospective case series study included nine patients (57 ± 12 years) with nine hip joints with advanced- or terminal-stage hip osteoarthritis who performed continuous daily jiggling exercises, beginning from day of hospitalization to 6 months post-discharge. Jiggling exercise was performed seated, using the KENKO YUSURI® automated heel vibrating machine at 3.3–5.0 Hz. The patients were also instructed against weight-bearing during hospitalization. The values of radiographic joint space width and Japanese Orthopaedic Association hip score for pain at hospital admission, discharge, and at the 6-month post-discharge checkup were evaluated. Although the hospitalization period and daily time spent performing the jiggling exercise varied in each case (27–98 days and 2–6 hours, respectively), the joint space width increased in all patients and there was an improvement in the hip pain scores in eight patients. The mean values of the minimum joint space width and hip pain scores at discharge were the highest compared to those at hospital admission and 6 months post-discharge. Our results suggest that intensive jiggling exercise for inpatients with advanced- and terminal-stage hip osteoarthritis leads to earlier improvement in joint space width and pain. Daily jiggling exercise for an adequate duration or in combination with non-weight-bearing practices may be a feasible conservative treatment for hip osteoarthritis.

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OARSI/OMERACT Criteria of Being Considered a Candidate for Total Joint Replacement in Knee/Hip Osteoarthritis as an Endpoint in Clinical Trials Evaluating Potential Disease Modifying Osteoarthritic Drugs

The Journal of Rheumatology ◽

10.3899/jrheum.090365 ◽

2009 ◽

Vol 36 (9) ◽

pp. 2097-2099 ◽

Cited By ~ 20

Author(s):

MAXIME DOUGADOS ◽

GILLIAN HAWKER ◽

STEFAN LOHMANDER ◽

AILEEN M. DAVIS ◽

PAUL DIEPPE ◽

...

Keyword(s):

Clinical Trials ◽

Joint Replacement ◽

Total Joint Replacement ◽

Task Force ◽

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Systematic Research ◽

Disease Modifying ◽

Space Width

Objective.A disease-modifying osteoarthritic drug (DMOAD) should interfere with the cartilage breakdown observed and improve symptoms or prevent deterioration of the patient’s clinical condition. We propose a composite index including structural and symptomatic variables of osteoarthritis (OA) as criteria for being considered a candidate for total joint replacement as an endpoint in clinical trials evaluating potential DMOAD.Methods.An OARSI/OMERACT task force conducted this study in 3 steps: (1) The 3 main domains — pain, function, structure — were revisited; (2) For each of the domains a “non-acceptable state” and a “relevant” progression for their structure were defined; and (3) a set of criteria was proposed combining the information from these 3 domains.Results.A questionnaire was elaborated for the domains “pain” and “function.” Systematic research of the literature and evaluation of different databases concluded that the domain “structure” should be evaluated by radiological joint space width in millimeters. An unacceptable radiographic progression was defined as a change in the joint space width over the measurement error. An international, cross-sectional study is proposing a definition of a “nonacceptable symptom state.”Conclusion.The objective of the ongoing OARSI/OMERACT initiative is to propose criteria for being considered a candidate for total joint replacement to be used as an endpoint in clinical trials evaluating potential DMOAD. The preliminary steps of this initiative have been completed.

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