Form-Function Relationships in Femoroacetabular Impingement Syndrome

项目摘要/摘要 据估计，髋臼撞击综合征(FAIS)占髋关节骨关节炎的82% 案子。出现股骨头球形丧失、股骨颈偏移量减少和/或股骨头移位的患者 髋臼壁过度突出，并报告与位置或运动相关的疼痛。公平正义论 病理生理学是病理解剖导致病理力学。然而，对这一点的量化理解 疾病是缺乏的。很少有研究者分析髋关节解剖和生物力学之间的关系。 在FAIS患者中；那些依赖于不完全描述髋关节形状的2D测量的人。基于这些 2D形态指标显示，约35%的普通人群携带一种无声形式的疾病，这阻碍了 了解FAI形态为什么会造成损害的进展。促进对FAIS的了解 病理生理学方面，将对FAIS患者和对照组进行横断面研究。目标1将量化 FAIS的病理形态。髋关节解剖将使用统计形状建模进行可视化和比较 (SSM)。值得注意的是，SSM在3D连续体上比较形状，而不是相对于单一的2D图像。这个 中心假设是SSM将检测有症状和无症状髋关节的3D形状的差异； 此外，无论对照是一起分析还是作为确定的解剖亚组进行分析，都会出现这种差异 通过聚类分析。目标1将提高对这种疾病的临床认识，并为更好的发展提供信息 评估髋关节解剖的技术。目标2将量化FAI的病理运动学。将测量髋关节的运动 在FAIS患者和对照组的功能活动中。中心假设是髋关节运动学将有所不同 FAIS患者和对照组之间的关系以及髋关节形状和髋关节之间存在显著关系 运动学；此外，髋关节形状与FAIS患者相似的对照组的运动学与 不支持的控件。目标2将通过更好地了解以下方面来指导治疗方案的开发 跨群体发生的补偿机制。培训计划是为促进实现以下目标而定制的 申请人通过发展科学和专业技能和机会实现的职业目标 产生和传播研究成果。培训计划使申请者和 犹他大学整形外科和理疗系赞助商，以及科学 计算和成像研究所。赞助商团队(安德鲁·安德森博士(主要导师)，施林 Elhabian，Kenneth“Bo”Foreman，Stephen Aoki)完全有资格培训申请人进行计算方面的培训 生物力学、高维数据分析技术、运动分析和髋关节的临床治疗 病理学。赞助商团队在成功的合作、指导、出版和 资金问题。获得F32奖学金将加强申请者和赞助商之间的协同作用，使 申请者充分利用大学强大的研究、临床和教育环境 并确保申请者成功地成为一名独立、有影响力的研究人员。

PROJECT SUMMARY/ABSTRACT By some estimates, femoroacetabular impingement syndrome (FAIS) accounts for 82% of hip osteoarthritis cases. Patients present with loss of femoral head sphericity, reduction in femoral-neck offset, and/or an excessively prominent acetabular wall, and report position- or motion-related pain. The theory of FAIS pathophysiology is that pathoanatomy causes pathomechanics. However, quantitative understanding of this disease is lacking. Few investigators have analyzed the relationship between hip anatomy and biomechanics in FAIS patients; those that have relied on 2D measures that incompletely describe hip shape. Based on these 2D shape metrics, ~35% of the general population carries a ‘silent’ form of the disease, which has hindered progress to understand why FAI morphology causes damage. To advance understanding of FAIS pathophysiology, a cross-sectional study of FAIS patients and controls will be performed. Aim 1 will quantify pathomorphology of FAIS. Hip anatomy will be visualized and compared using statistical shape modeling (SSM). Notably, SSM compares shape over the 3D continuum, rather than relative to a single, 2D image. The central hypothesize is that SSM will detect differences in 3D shape of symptomatic and asymptomatic hips; further, this difference will occur whether controls are analyzed together or as anatomic subgroups identified via cluster analysis. Aim 1 will improve clinical understanding of this disease and inform development of better techniques to evaluate hip anatomy. Aim 2 will quantify pathokinematics of FAIS. Hip motion will be measured during functional activities in FAIS patients and controls. The central hypothesis is that hip kinematics will differ between FAIS patients and controls and that significant relationships exist between hip shape and hip kinematics; further, controls with hip shape similar to FAIS patients will have altered kinematics compared to controls that do not. Aim 2 will guide development of treatment options through a better understanding of compensatory mechanisms that occur across groups. The training plan is tailored to facilitate achievement of the applicant’s career goals through development of scientific and professional skills and opportunities to generate and disseminate research findings. The training plan enables collaboration between the applicant and sponsors in the University of Utah Departments of Orthopaedics and Physical Therapy, and Scientific Computing and Imaging Institute. The sponsor team (Drs. Andrew Anderson (primary mentor), Shireen Elhabian, Kenneth “Bo” Foreman, Stephen Aoki) is well-qualified to train the applicant in computational biomechanics, analysis techniques for high-dimensional data, motion analysis, and clinical treatment of hip pathology. The sponsor team has a strong history of successful collaboration, mentorship, publication, and funding. Receipt of an F32 fellowship will enhance synergy between the applicant and sponsors, enable the applicant to take full advantage of the strong research, clinical, and educational environment at the University of Utah, and ensure the applicant success in becoming an independent, impactful researcher.