Acetabular Edge Loading During Gait Is Elevated by the Anatomical Deformities of Hip Dysplasia

Song, Ke; Pascual‐Garrido, Cecilia; Clohisy, John C.; Harris, Michael D.

doi:10.3389/fspor.2021.687419

Cited by 15 publications

(24 citation statements)

References 36 publications

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“…Computational studies have shown that the shallow acetabulum causes articular contact loads to shift laterally, which increases stress near the chondrolabral junction at the supero‐lateral acetabular edge 9,10 . Recently, we found that AEL from muscle‐induced forces throughout gait are also significantly elevated by the shallow antero‐superior acetabulum in dysplastic hips 11 . Such studies suggest bony anatomy as a major contributor to detrimental chondrolabral mechanics and the supero‐lateral acetabular damage often observed in patients with DDH 4 …”

Section: Introductionmentioning

confidence: 85%

“…9 Despite hip joint motion and loading patterns being different between gait and squat, elevated loading on the shallow supero-lateral acetabular edge was common for both movement tasks. 11 Considering the supero-lateral deficiency is almost universal in hips with DDH, 27 this region may be subject to mechanically induced tissue damage especially for patients whose daily living involves frequent squatting in addition to walking.…”

Section: Discussionmentioning

confidence: 99%

“…These subjects were a subset of the cohort for whom AEL during gait had been previously reported. 11 Controls were age-matched to the DDH patients within 1 year. All DDH patients were diagnosed by a single orthopaedic surgeon (J. C. C.), had unilateral hip pain lasting over 3 months, and radiographic evidence of DDH confirmed by a lateral center-edge angle (LCEA) < 20°.…”

Section: Subjects and Experimental Data Collectionmentioning

confidence: 99%

“…AEL on the analyzed hip during each squatting trial was computed by mathematically projecting hip JRFs onto the acetabular anatomy in each subject-specific model. 11 First, the acetabular rim was delineated on each MRI-based 3D pelvis, using a principal curvature contour map (Figure 3A). Then, on each acetabular rim, 9 clock-face points were designated within the anterior (2−4 O'clock), superior (11−1 O'clock), and posterior (8−10 O'clock) quadrants (Figure 3B).…”

Section: Aelmentioning

confidence: 99%

“…9,10 Recently, we found that AEL from muscle-induced forces throughout gait are also significantly elevated by the shallow antero-superior acetabulum in dysplastic hips. 11 Such studies suggest bony anatomy as a major contributor to detrimental chondrolabral mechanics and the supero-lateral acetabular damage often observed in patients with DDH. 4 However, bony anatomy alone cannot fully explain the variable types of joint damage in DDH.…”

mentioning

confidence: 99%

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Elevated loading at the posterior acetabular edge of dysplastic hips during double‐legged squat

Song

Pascual‐Garrido

Clohisy

et al. 2022

Journal Orthopaedic Research

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Hips with developmental dysplasia (DDH) are at a heightened risk of premature hip osteoarthritis, which is often expedited by mechanically induced articular tissue damage. A prevalent form of damage in DDH is labral tears caused by abnormal loading at the shallow acetabular edge. Although the majority of reported DDH‐related labral tears occur in the antero‐superior acetabulum, posterior labral tears are prevalent in individuals whose lifestyle involves frequent high hip flexion tasks such as squatting. To better understand region‐specific risks for chondrolabral damage during high hip flexion, we used image‐based musculoskeletal models to compare acetabular edge loading (AEL) during double‐legged squat between hips with symptomatic DDH (n = 10) and healthy controls (n = 10). Compared to controls, hips with DDH had higher instantaneous posterior AEL at the lowest point of squat (2.6 vs. 1.8 ×BW, p ≤ 0.04), and higher accumulative loading across the duration of the squatting motion (2.6 vs. 1.9 ×BW*s, p ≤ 0.04). Elevated posterior AEL coincided with increased net hip extension moments and posterior joint reaction forces, and was correlated with the severity of DDH acetabular deformity. Our findings suggest that posterior AEL is elevated in hips with symptomatic DDH during double‐legged squat, which may contribute to chondrolabral damage in individuals who often perform such high hip flexion tasks. Clinical evaluation of DDH should consider patient‐specific anatomy and lifestyle factors when establishing diagnoses and planning personalized treatment.

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Section: Introductionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Subjects and Experimental Data Collectionmentioning

confidence: 99%

Section: Aelmentioning

confidence: 99%

mentioning

confidence: 99%

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Elevated loading at the posterior acetabular edge of dysplastic hips during double‐legged squat

Song

Pascual‐Garrido

Clohisy

et al. 2022

Journal Orthopaedic Research

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Derotational femoral osteotomy locations and their influence on joint reaction forces in dysplastic hips

Shepherd

Clohisy

Nepple

et al. 2023

Journal Orthopaedic Research

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Femoral version (FV) deformities are common in patients with developmental dysplasia of the hip (DDH) and may contribute to cartilage damage due to abnormal joint loading. Derotational femoral osteotomy (DFO) surgery corrects FV deformities. However there is little consensus about the femoral transection location for DFO, and its influence on joint loads is unknown. The purpose of this study was to compare the effects of two common DFO locations on muscle forces and hip joint reaction forces (JRFs) in patients with DDH. DFO was simulated in nine patients with DDH and abnormal FV using patient‐specific musculoskeletal models. Femoral transection for DFO was separately simulated proximal and distal to the lesser trochanter and FV values were corrected to an idealized 15°. JRFs during early and late stance of gait were compared between the two simulated transection locations. Most changes to JRFs were similar between proximal and distal DFO, however, statistically significant differences were found for the medial JRF component during late stance among patients with femoral anteversion (p = 0.01). Force changes from five hip muscles were significantly different between DFO locations, however, changes were minimal. Most changes after DFO in patients with femoral retroversion were opposite of those with femoral anteversion, with anteroposterior and superior JRFs increasing after retroversion correction. After DFO correction, superior and medial JRFs in DDH patients remained elevated compared to controls. Understanding the influence of DFO location on muscle‐generated hip forces can help surgeons justify decisions and potentially standardize surgical correction of FV deformities in patients with DDH.

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Bewegungsstörungen des Hüftgelenks

Maurer

2024

Clinical Reasoning Der Unteren Extremität

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Acetabular Edge Loading During Gait Is Elevated by the Anatomical Deformities of Hip Dysplasia

Cited by 15 publications

References 36 publications

Elevated loading at the posterior acetabular edge of dysplastic hips during double‐legged squat

Elevated loading at the posterior acetabular edge of dysplastic hips during double‐legged squat

Derotational femoral osteotomy locations and their influence on joint reaction forces in dysplastic hips

Bewegungsstörungen des Hüftgelenks

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