Acetabular labrum and cartilage contact mechanics during pivoting and walking tasks in individuals with cam femoroacetabular impingement syndrome.
Acetabular labrum and cartilage contact mechanics during pivoting and walking tasks in individuals with cam femoroacetabular impingement syndrome.
复制标题
患有凸轮股骨髋臼撞击综合征的个体在旋转和行走任务期间髋臼盂唇和软骨接触力学。
DOI：
10.1016/j.jbiomech.2022.111424
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发表时间：
2023
影响因子：
2.4
通讯作者：
Anderson,AndrewE
中科院分区：
文献类型：
--
作者：
Schuring,LindsayL;Mozingo,JosephD;Lenz,AmyL;Uemura,Keisuke;Atkins,PennyR;Fiorentino,NiccoloM;Aoki,StephenK;Peters,ChristopherL;Anderson,AndrewE
股骨髋臼撞击综合征（FAIS）是一种与髋关节运动相关的病理学，其特征为疼痛、股骨近端形态异常以及关节恶化和髋关节骨关节炎的风险升高。需要深屈曲的活动被认为会引起凸轮FAIS患者的撞击，然而，要求较低的活动（如行走和旋转）可能会引起疼痛以及运动学和关节稳定性的改变。尽管如此，凸轮FAIS的定量描述的缺乏，阻碍了了解潜在的髋关节力学在这样的活动。先前的计算机研究采用广义模型几何学或运动学来模拟股骨和髋臼之间的撞击，这可能无法准确捕获形态和运动之间的相互作用。在这项研究中，我们利用参与者特定的骨骼和关节软组织解剖和运动学模型，通过双透视测量，比较凸轮FAIS患者的髋关节接触力学，以控制在四种日常生活活动（内部/外部旋转和水平/倾斜行走）。在倾斜行走期间，平均整个步态周期，患者显示前关节应变增加（盂唇应变：p值= 0.038，患者：11.7 ± 6.7%，对照组：5.0 ± 3.6%;软骨应变：p值= 0.029，患者：9.1 ± 3.3%，对照组：4.2 ± 2.3）。患者在外部旋转期间还表现出平均前软骨应变增加（p值= 0.039;患者：13.0 ± 9.2%，对照：3.9 ± 3.2%]）。水平行走和内旋转时，患者和对照组的接触面积和应变无显著差异。我们的研究为凸轮FAIS的生物力学提供了新的见解，包括日常生活活动中的时空髋关节接触力学。
Femoroacetabular impingement syndrome (FAIS) is a motion-related pathology of the hip characterized by pain, morphological abnormalities of the proximal femur, and an elevated risk of joint deterioration and hip osteoarthritis. Activities that require deep flexion are understood to induce impingement in cam FAIS patients, however, less demanding activities such as walking and pivoting may induce pain as well as alterations in kinematics and joint stability. Still, the paucity of quantitative descriptions of cam FAIS has hindered understanding underlying hip joint mechanics during such activities. Previousin silicostudies have employed generalized model geometry or kinematics to simulate impingement between the femur and acetabulum, which may not accurately capture the interplay between morphology and motion. In this study, we utilized models with participant-specific bone and articular soft tissue anatomy and kinematics measured by dual-fluoroscopy to compare hip contact mechanics of cam FAIS patients to controls during four activities of daily living (internal/external pivoting and level/incline walking). Averaged across the gait cycle during incline walking, patients displayed increased strain in the anterior joint (labrum strain: p-value = 0.038, patients: 11.7 ± 6.7 %, controls: 5.0 ± 3.6 %; cartilage strain: p-value = 0.029, patients: 9.1 ± 3.3 %, controls: 4.2 ± 2.3). Patients also exhibited increased average anterior cartilage strains during external pivoting (p-value = 0.039; patients: 13.0 ± 9.2 %, controls: 3.9 ± 3.2 %]). No significant differences between patient and control contact area and strain were found for level walking and internal pivoting. Our study provides new insights into the biomechanics of cam FAIS, including spatiotemporal hip joint contact mechanics during activities of daily living.