Morphological and Biomechanical Insights into the Pathophysiology of Femoroacetabular Impingement Syndrome

股髋臼撞击综合征病理生理学的形态学和生物力学见解

• 批准号: 10032655
• 负责人: Andrew Edward Anderson
• 金额: $ 48.28万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10032655
• 关键词: Anatomy; Animal Model; Arthrography; Articular Range of Motion; Articulation; Biomechanics; Cartilage; Clinical; Computational Technique; Conflict (Psychology); Control Groups; Data; Deformity; Degenerative polyarthritis; Development; Diagnosis; Diagnostic radiologic examination; Disease; Elements; Etiology; Evaluation; Exhibits; Film; Finite Element Analysis; Fluoroscopy; Functional disorder; Growth; Head; High Prevalence; Hip Joint; Hip Osteoarthritis; Hip region structure; Image; Individual; Injury; Intuition; Joints; Lead; Left; Location; Magnetic Resonance; Measurement; Measures; Mechanics; Methods; Modeling; Morphology; Motion; Neck; Operative Surgical Procedures; Outcome; Pain; Pathogenesis; Pathologic; Patients; Population; Positioning Attribute; Procedures; Replacement Arthroplasty; Reporting; Research; Resource Sharing; Scanning; Shapes; Stress; Structure; Symptoms; Syndrome; Techniques; Technology; Traction; Translations; Walking; aged; bone; cohort; design; experience; gait rehabilitation; improved; in silico; in vivo; innovation; insight; kinematics; novel strategies; osteochondral tissue; pain relief; pathomechanics; shear stress; success; theories; treatment strategy; young adult

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 apply experimental and computational techniques to advance understanding of FAIS pathophysiology. We will examine three cohorts: FAIS patients, negative controls, and positive controls. Aim 1 will measure in-vivo hip articulation during inclined walking, pivoting, and squatting in the three cohorts using dual fluoroscopy. We hypothesize that patients with FAIS will exhibit altered kinematics; however, given our preliminary data, we posit that range of motion will not be reduced in patients. Further, we hypothesize that positive controls will have altered kinematics when compared to negative controls. In Sub-Aim 1, we will visualize the interaction between the shape of the hip joint and its kinematic position during dynamic loading using statistical shape modeling of the dual fluoroscopy data. Completion of Aim 1 improve clinical understanding of FAIS by enabling us to visualize the effects of pathologic shape during dynamic loading. Aim 2 will analyze chondrolabral mechanics in-silico to improve understanding of FAIS pathophysiology. Specifically, we will generate finite element models of bone, cartilage, and labrum using a validated pipeline. We will compare load transfer to the labrum and shear stresses and strains at the osteochondral and chondrolabral junction during inclined walking, pivoting, and squatting. We hypothesize that load transfer to the labrum is increased, and cartilage shear stresses and strains at the osteochondral and chondrolabral junctions are elevated in FAIS patients. Compensatory motion experienced by the positive control group may keep chondrolabral stresses and strains within normal. Thus, we hypothesize that there will be no significant differences in FE results between the two control groups. Sub-Aim 2 will quantify relationships between local measures of hip shape and chondrolabral mechanics. Completion of Aim 2 will enhance understanding of OA pathogenesis in patients with FAIS. Identifying how positive controls cope with their deformities could inform new treatment strategies.

项目概要 据估计，股骨髋臼撞击综合征 (FAIS) 占髋骨关节炎的 82% (OA) 案例。 FAIS 患者表现为股骨头球形度丧失、股骨颈偏移减少、 和/或髋臼壁过度突出。患者报告与位置或运动相关的疼痛。经常， 软骨与骨分层，盂唇撕裂。 FAIS 病理生理学理论是 病理解剖学引起病理力学。然而，我们缺乏对该疾病的定量了解。研究 对 FAIS 患者的髋关节解剖学和生物力学进行检查后得出了相互矛盾的数据，可能是由于 应用不准确的测量技术。 FAI 形态也很常见 在无症状人群（即阳性对照）中，这阻碍了理解 FAI 原因的进展 形态造成损害。在这里，我们应用实验和计算技术来推进 了解 FAIS 病理生理学。我们将检查三个队列：FAIS 患者、阴性对照和 阳性对照。目标 1 将测量倾斜行走、旋转和蹲下期间的体内髋关节 三个队列使用双透视。我们假设 FAIS 患者会表现出运动学改变； 然而，根据我们的初步数据，我们认为患者的活动范围不会减少。此外，我们 假设与阴性对照相比，阳性对照会改变运动学。在子目标中 1，我们将可视化动态过程中髋关节形状与其运动位置之间的相互作用 使用双透视数据的统计形状建模进行加载。完成目标 1 改善临床 通过使我们能够可视化动态加载期间病理形状的影响来理解 FAIS。目的 2 将分析软骨盂力学，以提高对 FAIS 病理生理学的理解。具体来说， 我们将使用经过验证的管道生成骨骼、软骨和盂唇的有限元模型。我们会比较 载荷转移到盂唇以及骨软骨和软骨盂唇交界处的剪切应力和应变 倾斜行走、旋转和蹲下。我们假设转移到盂唇的负荷增加，并且 FAIS 中骨软骨和软骨盂连接处的软骨剪应力和应变升高 患者。阳性对照组经历的代偿性运动可能会保持软骨盂应力和 应变在正常范围内。因此，我们假设 FE 结果不会有显着差异 两个对照组。子目标 2 将量化臀部形状的局部测量值与 软骨盂力学。完成目标 2 将增强对 OA 发病机制的了解 FAIS。确定阳性对照如何应对其畸形可以为新的治疗策略提供信息。