Dysplastic hip anatomy alters muscle moment arm lengths, lines of action, and contributions to joint reaction forces during gait.
Dysplastic hip anatomy alters muscle moment arm lengths, lines of action, and contributions to joint reaction forces during gait.
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DOI：
10.1016/j.jbiomech.2020.109968
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发表时间：
2020-09-18
影响因子：
2.4
通讯作者：
Harris MD
中科院分区：
文献类型：
--
作者：
Song K;Gaffney BMM;Shelburne KB;Pascual-Garrido C;Clohisy JC;Harris MD
发育性髋关节发育不良（DDH）的特点是骨解剖结构异常，导致有害的髋关节负荷，并导致继发性骨关节炎。髋关节负荷部分取决于肌肉诱导的关节反作用力（JRF），因此受髋肌肉力矩臂长度（MAL）和作用线（LoA）的影响。本研究使用受试者特定的肌肉骨骼模型和体内运动分析来量化DDH骨骼解剖结构对动态肌肉MAL、LoA的影响，以及它们对步态早期（~17%）和后期（~52%）JRF峰值的贡献。与健康髋关节（N = 15，16-39岁）相比，未接受治疗的DDH患者（N = 15，16-39岁）的外展肌MAL较小（例如，站立早期臀中肌前肌，35.3 mm vs. 41.6 mm，站立晚期45.4 mm vs. 52.6 mm，p ≤ 0.01），LoA更偏向内侧。外展-内收和旋转MAL在主要髋屈肌（如股直肌和髂肌）上也不同。DDH中MAL的改变对应于较高的髋外展肌力、内侧JRF（1.26 vs. 0.87 × BW早期站立，p = 0.03）和由此产生的JRF（5.71 vs. 4.97 × BW晚期站立，p = 0.05）。DDH解剖结构不仅影响髋关节主要功能平面的肌力生成，而且影响其平面外力学，这共同提高了JRF。总的来说，髋关节肌肉MALs及其对JRF的贡献被DDH骨解剖结构显著改变。因此，为了更好地了解关节退变的机制，提高治疗效果的DDH，动态解剖力的关系和整个髋关节肌肉系统的多平面功能，必须共同考虑。
Developmental dysplasia of the hip (DDH) is characterized by abnormal bony anatomy, which causes detrimental hip joint loading and leads to secondary osteoarthritis. Hip joint loading depends, in part, on muscle-induced joint reaction forces (JRFs), and therefore, is influenced by hip muscle moment arm lengths (MALs) and lines of action (LoAs). The current study used subject-specific musculoskeletal models and in-vivo motion analysis to quantify the effects of DDH bony anatomy on dynamic muscle MALs, LoAs, and their contributions to JRF peaks during early (~17%) and late-stance (~52%) of gait. Compared to healthy hips (N = 15, 16–39 y/o), the abductor muscles in patients with untreated DDH (N = 15, 16–39 y/o) had smaller abduction MALs (e.g. anterior gluteus medius, 35.3 vs. 41.6 mm in early stance, 45.4 vs. 52.6 mm late stance, p ≤ 0.01) and more medially-directed LoAs. Abduction-adduction and rotation MALs also differed for major hip flexors such as rectus femoris and iliacus. The altered MALs in DDH corresponded to higher hip abductor forces, medial JRFs (1.26 vs. 0.87 × BW early stance, p = 0.03), and resultant JRFs (5.71 vs. 4.97 × BW late stance, p = 0.05). DDH anatomy not only affected hip muscle force generation in the primary plane of function, but also their out-of-plane mechanics, which collectively elevated JRFs. Overall, hip muscle MALs and their contributions to JRFs were significantly altered by DDH bony anatomy. Therefore, to better understand the mechanisms of joint degeneration and improve the efficacy of treatments for DDH, the dynamic anatomy-force relationships and multi-planar functions of the whole hip musculature must be collectively considered.
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影响因子：
2.3
作者：
Liu R;Wen X;Tong Z;Wang K;Wang C
通讯作者：
Wang C
影响因子：
2.5
作者：
Hermens, HJ;Freriks, B;Rau, G
通讯作者：
Rau, G
影响因子：
3.2
作者：
Lewis, CL;Sahrmann, SA
通讯作者：
Sahrmann, SA
DOI：
10.1302/0301-620x.67b5.4055873
发表时间：
1985-01-01
影响因子：
--
作者：
HARDCASTLE, P;NADE, S
通讯作者：
NADE, S
影响因子：
2.4
作者：
Harris, Michael D.;MacWilliams, Bruce A.;Anderson, Andrew E.
通讯作者：
Anderson, Andrew E.