Acetabular Edge Loading During Gait Is Elevated by the Anatomical Deformities of Hip Dysplasia.
Acetabular Edge Loading During Gait Is Elevated by the Anatomical Deformities of Hip Dysplasia.
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DOI：
10.3389/fspor.2021.687419
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发表时间：
2021
影响因子：
2.7
通讯作者：
Harris MD
中科院分区：
文献类型：
--
作者：
Song K;Pascual-Garrido C;Clohisy JC;Harris MD
髋关节发育不良（DDH）是关节组织损伤和继发性髋关节骨关节炎的已知风险因素。髋臼盂唇撕裂在DDH髋关节中很常见，可能是由于浅髋臼边缘的过度载荷所致。盂唇撕裂的位置特异性风险也可能取决于神经肌肉因素，如运动模式和肌肉诱导的髋关节反作用力（JRF）。为了评估这种机械引起的风险，我们使用受试者特定的肌肉骨骼模型来比较DDH（N = 15）和健康对照（N = 15）个体在步态期间的髋臼边缘载荷（AEL），并确定AEL和DDH髋臼解剖结构的放射学测量之间的关联。每个DDH和对照受试者的三维骨盆和股骨解剖结构由磁共振图像重建，并用于个性化每个模型中的髋关节中心位置和肌肉路径。模型估计的髋关节JRF被投射到三维髋臼边缘上，以预测瞬时AEL力及其在整个步态周期中的累积脉冲。与对照组相比，尽管髋关节运动模式相似，但DDH受试者在站立早期（3.6 vs. 2.8 × BW，p ≤ 0.01）、站立晚期（4.3 vs. 3.3 × BW，p ≤ 0.05）和整个步态周期（1.8 vs. 1.4 × BW*s，p ≤ 0.02）的髋臼前上方的AEL显著较高。AEL升高主要发生在髋臼浅边缘靠近髋关节JRF方向的区域，并且与髋臼畸形的放射学严重程度密切相关。结果表明，AEL是高度依赖于运动和肌肉诱导的关节负荷，并显着增加DDH髋臼畸形。
Developmental dysplasia of the hip (DDH) is a known risk factor for articular tissue damage and secondary hip osteoarthritis. Acetabular labral tears are prevalent in hips with DDH and may result from excessive loading at the edge of the shallow acetabulum. Location-specific risks for labral tears may also depend on neuromuscular factors such as movement patterns and muscle-induced hip joint reaction forces (JRFs). To evaluate such mechanically-induced risks, we used subject-specific musculoskeletal models to compare acetabular edge loading (AEL) during gait between individuals with DDH (N = 15) and healthy controls (N = 15), and determined the associations between AEL and radiographic measures of DDH acetabular anatomy. The three-dimensional pelvis and femur anatomy of each DDH and control subject were reconstructed from magnetic resonance images and used to personalize hip joint center locations and muscle paths in each model. Model-estimated hip JRFs were projected onto the three-dimensional acetabular rim to predict instantaneous AEL forces and their accumulative impulses throughout a gait cycle. Compared to controls, subjects with DDH demonstrated significantly higher AEL in the antero-superior acetabulum during early stance (3.6 vs. 2.8 × BW, p ≤ 0.01), late stance (4.3 vs. 3.3 × BW, p ≤ 0.05), and throughout the gait cycle (1.8 vs. 1.4 × BW*s, p ≤ 0.02), despite having similar hip movement patterns. Elevated AEL primarily occurred in regions where the shallow acetabular edge was in close proximity to the hip JRF direction, and was strongly correlated with the radiographic severity of acetabular deformities. The results suggest AEL is highly dependent on movement and muscle-induced joint loading, and significantly elevated by the DDH acetabular deformities.
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影响因子：
3.2
作者：
Lewis, CL;Sahrmann, SA
通讯作者：
Sahrmann, SA
影响因子：
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作者：
Santori, N;Villar, RN
通讯作者：
Villar, RN
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Goronzy, Jens;Blum, Sophia;Thielemann, Falk
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作者：
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