Antalgic gait, limp, osteoarthritis - what happens to the weight-bearing joints?

WorkSafeBC Evidence-Based Practice Group, Martin CW
Record ID 32018004202
Authors' objectives: To explore whether antalgic gait, limping, or degenerative joint disease (e.g., osteoarthritis) cause or accelerate degenerative disease in the opposite (contralateral) and/or the same side (ipsilateral) weight-bearing joints.
Authors' results and conclusions: After our initial search, nine articles met our inclusion criteria and were collected in full text and reviewed. Patient characteristics (e.g., age, gender), joint biomechanics (e.g., loading forces, leg length inequality), time since the initial degenerative joint disease and initial joint surgery, all play a role in the development of degenerative disease in other weight-bearing joints. The majority of the studies, currently available through the peer-reviewed literature on the topic are case series, generally with small sample sizes. In the cohort studies we included in this review, generally joint ?arthroplasty? was used as a surrogate marker for end-stage osteoarthritis (OA) and majority of these studies lacked proper radiologic imaging to determine the development of OA through the follow-up period. To determine whether antalgic gait, limping, or OA cause or accelerate degenerative disease in the opposite or the same side weight-bearing joints longitudinal, prospective studies with larger sample sizes and with full radiologic and clinical measurements are required. The current level of evidence is not sufficient to make causal inferences on this matter (Level of Evidence 3); however, the available research does suggest that leg length discrepancy may increase the risk of radiologically detectable OA in hip and knee joints.
Authors' methods: A systematic literature search was conducted on April 25, 2022 using commercial databases under the Ovid and EBSCO platforms. Articles were included in this review if they were about antalgic gait/limping or degenerative joint disease of the lower extremities, reported on the development or acceleration of degenerative disease in the opposite (contralateral) and/or the same side (ipsilateral) lower extremity weight-bearing joints, and were comparative studies, case series, RCTs, systematic reviews/meta-analyses, cohort studies, case-control studies.
Project Status: Completed
Year Published: 2022
English language abstract: An English language summary is available
Publication Type: Mini HTA
Country: Canada
MeSH Terms
  • Gait
  • Osteoarthritis
  • Osteoarthritis, Hip
  • Osteoarthritis, Knee
  • Hip Joint
  • Knee Joint
  • Walking
  • antalgic gait
  • limping
  • paralytic gait
  • leg length discrepancy
  • overuse syndromes
  • over compensating
  • osteoarthritis
  • weight-bearing joint
  • ankle
  • knee
  • hip
  • ipsilateral
  • contralateral
  • degenerative joint disease
Organisation Name: WorkSafeBC
Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698
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Copyright: WorkSafe BC
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.