Higher medially-directed joint reaction forces are a characteristic of dysplastic hips: A comparative study using subject-specific musculoskeletal models
Higher medially-directed joint reaction forces are a characteristic of dysplastic hips: A comparative study using subject-specific musculoskeletal models
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DOI：
10.1016/j.jbiomech.2017.01.040
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发表时间：
2017-03-21
影响因子：
2.4
通讯作者：
Anderson, Andrew E.
中科院分区：
文献类型：
--
作者：
Harris, Michael D.;MacWilliams, Bruce A.;Anderson, Andrew E.
髋臼发育不良是髋关节骨关节炎的已知原因。除了解剖结构异常外，运动学、关节反作用力（JRF）和肌肉力量的变化可能导致软骨和盂唇的组织损伤，并可能导致疼痛和疲劳。本研究的目的是比较有症状的髋臼发育不良患者和健康对照者在步态中的下肢关节角度、力矩、髋关节JRF和肌肉力量。标记轨迹和地面反作用力进行了测量，在10个发育异常患者和10个典型的发展对照组。在OpenSim中将肌肉骨骼模型按比例缩放到每个受试者，并使用CT图像重建确定受试者特定的髋关节中心。分别采用逆运动学和逆动力学计算关节运动学和力矩。肌肉力量和髋关节JRF估计静态优化。检验组间差异的统计学显著性（p = 0.8）。结果表明，异型增生患者有较高的中间指向JRF。两组之间的关节角度和力矩基本相似，但组间效应量较大，表明患者髋关节和踝关节的活动范围受到一定限制。较高的内侧指向JRF和髋关节肌力的组间差异可能源于发育不良患者髋关节中心的偏侧化。关节力的差异，结合髋关节和踝关节活动范围的减少，也可能表明发育不良患者为维持关节稳定性而采取的代偿策略。(C)2017爱思唯尔有限公司版权所有
Acetabular dysplasia is a known cause of hip osteoarthritis. In addition to abnormal anatomy, changes in kinematics, joint reaction forces (JRFs), and muscle forces could cause tissue damage to the cartilage and labrum, and may contribute to pain and fatigue. The objective of this study was to compare lower extremity joint angles, moments, hip JRFs and muscle forces during gait between patients with symptomatic acetabular dysplasia and healthy controls. Marker trajectories and ground reaction forces were measured in 10 dysplasia patients and 10 typically developing control subjects. A musculoskeletal model was scaled in OpenSim to each subject and subject-specific hip joint centers were determined using reconstructions from CT images. Joint kinematics and moments were calculated using inverse kinematics and inverse dynamics, respectively. Muscle forces and hip JRFs were estimated with static optimization. Inter-group differences were tested for statistical significance (p = 0.8). Results demonstrated that dysplasia patients had higher medially directed JRFs. Joint angles and moments were mostly similar between the groups, but large inter-group effect sizes suggested some restriction in range of motion by patients at the hip and ankle. Higher medially-directed JRFs and inter-group differences in hip muscle forces likely stem from lateralization of the hip joint center in dysplastic patients. Joint force differences, combined with reductions in range of motion at the hip and ankle may also indicate compensatory strategies by patients with dysplasia to maintain joint stability. (C) 2017 Elsevier Ltd. All rights reserved.