Quantifying the Pathophysiology of Femoroacetabular Impingement Syndrome

量化股髋臼撞击综合征的病理生理学

• 批准号: 9985290
• 负责人: Andrew Edward Anderson
• 金额: $ 31.6万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9985290
• 关键词: 3-Dimensional; Anatomy; Area; Arthrography; Biomechanics; Cartilage; Clinical; Collagen; Conflict (Psychology); Control Groups; Data; Deformity; Degenerative polyarthritis; Development; Diagnosis; Diagnostic radiologic examination; Disease; Elements; Etiology; Femur; Film; Financial compensation; Fluoroscopy; Foundations; Functional disorder; Head; Health; High Prevalence; Hip Joint; Hip Osteoarthritis; Hip region structure; Image; Imaging Techniques; Individual; Knowledge; Link; Magnetic Resonance; Magnetic Resonance Imaging; Maps; Measurement; Measures; Mechanics; Methods; Modeling; Monitor; Morphology; Motion; Neck; Operative Surgical Procedures; Pain; Participant; Pathogenesis; Patients; Pelvis; Play; Population; Positioning Attribute; Process; Proteoglycan; Recording of previous events; Reporting; Research; Role; Scanning; Scientific Advances and Accomplishments; Sex Behavior; Shapes; Statistical Distributions; Stress; Surface; Symptoms; Syndrome; Techniques; Technology; Testing; Walking; bone; cohort; design; improved; in vivo; insight; interest; kinematics; osteochondral tissue; pathomechanics; shear stress; theories

PROJECT SUMMARY By some estimates, femoroacetabular impingement syndrome (FAIS) accounts for 82% of hip osteoarthritis (OA) cases. FAIS patients present with a loss of sphericity of the femoral head, reduction in femoral-neck offset, and/or an excessively prominent acetabular wall. Patients report pain that is position- or motion-related. Often, cartilage is delaminated from bone and the labrum is torn. The theory of FAIS pathophysiology is that pathoanatomy causes pathomechanics. However, we lack a quantitative understanding of the disease. Studies that have examined hip anatomy and biomechanics in FAIS patients have yielded conflicting data, likely due to the application of inaccurate measurement techniques. There is also a high prevalence of FAI morphology among the asymptomatic population (i.e., positive controls), which has hindered progress to understand why FAI morphology causes damage. Herein, we improve our understanding of FAIS pathophysiology. We propose a cross-sectional design with three cohorts: FAIS patients, negative controls, and positive controls. Aim 1 will quantify the pathomorphology of FAIS. More specifically, we will visualize and compare 3D hip anatomy using statistical shape modeling. We hypothesize shape modeling will detect differences in the 3D shape of the pelvis and proximal femur between symptomatic and asymptomatic hips; we posit this difference will occur whether controls are analyzed together or as separate positive/negative groups. Completion of Aim 1 will improve our clinical understanding of this disease and inform the development of better radiographic imaging techniques to evaluate hip anatomy. Aim 2 will quantify the pathomechanics of FAIS. More specifically, we will quantify in-vivo hip kinematics using dual fluoroscopy and chondrolabral mechanics using patient-specific finite element models. We hypothesize hip kinematics are altered, load transfer to the labrum is increased, and cartilage shear stresses and strains at the osteochondral and chondrolabral junctions are elevated in FAIS patients. We theorize individuals in the positive control group cope with FAI morphology through alterations in hip joint motion, which serve to keep chondrolabral mechanics within the normative range (i.e. no difference in FE predictions between positive and negative controls). Aim 2 will improve our clinical understanding of FAIS by enabling us to ‘see’ the disease process during dynamic loading. Aim 2 data will also guide development of new treatment options through a better understanding of compensation mechanisms that occur across the three groups. Aim 3 will improve our understanding of the pathogenesis of OA in hips with FAIS by identifying relationships between anatomy, chondral mechanics, and cartilage ultrastructure. Here, quantitative magnetic resonance imaging will estimate proteoglycan content and collagen organization within hip cartilage. These data may also inform new methods to diagnose, stage, and monitor the disease.

项目摘要 据估计，股骨髋臼撞击综合征（FAIS）占髋关节骨关节炎的82 (OA)例FAIS患者表现为股骨头球形度丧失，股骨颈减少， 偏移和/或髋臼壁过度突出。患者报告疼痛与体位或运动相关。 通常情况下，软骨从骨上剥离，盂唇撕裂。FAIS病理生理学的理论是 病理解剖学导致病理力学。然而，我们对这种疾病缺乏定量的了解。研究 在FAIS患者中检查髋关节解剖结构和生物力学的研究产生了相互矛盾的数据，可能是由于 使用不准确的测量技术。FAI形态学的患病率也很高 在无症状人群中（即，阳性对照），这阻碍了了解原因的进展 FAI形态导致损坏。在此，我们提高我们的理解FAIS的病理生理学。我们提出 采用三个队列的横断面设计：FAIS患者、阴性对照和阳性对照。 目的1将量化FAIS的病理形态学。更具体地说，我们将可视化并比较3D髋关节 使用统计形状建模的解剖学。我们假设形状建模将检测3D中的差异， 有症状和无症状髋关节之间的骨盆和股骨近端的形状;我们证实了这一差异 无论对照是一起分析还是作为单独的阳性/阴性组分析，均会发生。完成目标1 将提高我们对这种疾病的临床认识，并为更好的放射学检查提供信息。 影像学技术来评估髋关节解剖结构。 目标2将量化FAIS的病理机制。更具体地说，我们将量化体内髋关节运动学 使用双透视和使用患者特定有限元模型的软骨盂唇力学。我们 假设髋关节运动学改变，向盂唇的负荷转移增加， FAIS患者骨软骨和软骨盂唇连接处的应变增加。我们推测 阳性对照组的个体通过改变髋关节运动来科普FAI形态， 用于将软骨盂唇力学保持在标准范围内（即FE预测无差异 阳性和阴性对照之间）。目标2将通过使我们能够更好地了解FAIS， 在动态加载过程中“看到"疾病过程。AIM 2的数据也将指导新疗法的开发 通过更好地了解这三个群体的补偿机制， 目的3：通过识别FAIS患者的髋关节OA， 解剖学、软骨力学和软骨超微结构之间的关系。在这里，定量磁力 共振成像将估计髋关节软骨内的蛋白聚糖含量和胶原组织。这些 数据还可以为诊断、分期和监测疾病的新方法提供信息。