Dynamic femoral head translations in dysplastic hips

Shimoda, Tatsuya; Tanino, Hiromasa; Nishida, Yasuhiro; Ito, Hiroshi; Matsuno, Takeo; Banks, Scott A.

doi:10.1016/j.clinbiomech.2017.05.003

Cited by 16 publications

(15 citation statements)

References 51 publications

(46 reference statements)

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“…Thus, the motion of the joint approximates a pure ball-and-socket joint in these positions. This finding is consistent with the results of Sato et al, 34,35 who reported that during walking (peak flexion angle, approximately 35°), the superior-inferior component of femoral head translation was within 0.5 mm. Similarly, Akiyama et al 3 showed that from neutral to 15° of extension, theindividual components were between 0.15 mm and 0.57 mm, with the 3-dimensional resultant translation <0.86 mm.…”

Section: Discussionsupporting

confidence: 93%

“…16,20,32,36 Moreover, little detailed information exists defining the normal motion of the hip during functional activities, especially at the resolution required to separate physiologic from pathologic motion, which previous studies of labral mechanics showed to occur at the submillimeter level. 28,34,35 In view of this absence of fundamental information concerning the kinematics of the hip and the contribution of the joint capsule, we performed an experimental study to answer the following questions:…”

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confidence: 99%

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Does Capsular Laxity Lead to Microinstability of the Native Hip?

et al. 2018

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Section: Discussionsupporting

confidence: 93%

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confidence: 99%

Does Capsular Laxity Lead to Microinstability of the Native Hip?

et al. 2018

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“…The findings in this study should be interpreted with the understanding that these limitations may significantly bias the results. However, this cohort is similar to that in previous hip kinematic studies (eight healthy and twelve DDH hips [44], eight [45] or eleven [46] replaced hips) due to the demanding study protocol with radiographic surveillances, CT scans, and density-based image-matching techniques, and is consistent with minimizing X-ray exposure to individuals, and the studies nevertheless obtained important information. Second, we only evaluated the kinematics of the hip joint during a squatting.…”

Section: Discussionsupporting

confidence: 84%

Dynamic hip kinematics before and after periacetabular osteotomy in patients with dysplasia

Yoshimoto

Hamai

Higaki

et al. 2020

Journal of Orthopaedic Science

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Background: We prospectively analyzed the hip kinematics in patients with developmental dysplasia of the hip (DDH) before and after periacetabular osteotomy (PAO) and in healthy subjects while squatting to determine the influence of coverage of the femoral head on hip kinematics. Methods: 14 hips in 14 patients with DDH and 10 hips in 10 volunteers were included. Continuous radiographs while squatting and computed tomography images were obtained to assess the in vivo kinematics of the hip and the rim-neck distance using density-based 3D-to-2D model-to-image registration techniques. Results: The maximum hip flexion angles were 100.4 and 94.9 before and after PAO (p ¼ 0.0863), respectively. The maximum hip flexion angles after PAO did not significantly differ from those of normal hips (102.2 ; p ¼ 0.2552). The hip abduction angles at maximum hip flexion were 31.7 and 26.2 before and after PAO (p ¼ 0.1256), respectively. The rim-neck distance decreased from averaged 12.2 mm e8.9 mm (p ¼ 0.0044) after PAO. The lateral center edge angle (LCEA) and anterior center edge angle (ACEA) significantly improved 14.7 e42.4 and 50.4 e54.0 after PAO (p < 0.0001, p ¼ 0.0347), respectively; in particular, the ACEA after PAO did not significantly differ from that in the normal hips (p ¼ 0.1917). The ACEA was not correlated with hip flexion, or the rim-neck distance (p ¼ 0.9601, 0.8764). The LCEA was also not correlated with hip abduction (p ¼ 0.1683). Conclusion: Patients after PAO showed no significant difference in maximum hip flexion while squatting compared to before PAO and normal hips. Horizontalized weight-bearing acetabulum with normalized ACEA could be adequate correction of the acetabular fragment to restore hip RoM without coxalgia that induce the inability to perform squats after PAO.

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“…The hip is subjected to distraction forces throughout most activities of daily living, with fluoroscopic evidence of hip subluxation during the swing phase of gait. 8,18,19,31 Resultant instability from an incongruent capsule may lead to an increased incidence and degree of subluxation, which can accelerate joint damage and result in poor outcomes. 29,39 Arthroscopic capsular reconstruction should therefore be considered for patients with irreparable capsular defects to significantly improve hip distractive stability.…”

Section: Discussionmentioning

confidence: 99%

“…2,14,30,36 The role of the capsule in maintaining distractive stability of the hip (ie, the hip’s ability to resist distractive force) has yet to be elucidated, despite the fact that the hip joint is subjected to distractive forces throughout activities of daily living. 8,18,19,31 Repetitive subluxation and joint instability have been cited as factors for accelerated joint degeneration and revision surgery. 29,39 To the authors’ knowledge, no biomechanical study has investigated distractive stability in the capsular reconstruction state.…”

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confidence: 99%

Effects of Capsular Reconstruction With an Iliotibial Band Allograft on Distractive Stability of the Hip Joint: A Biomechanical Study

et al. 2018

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Background: The capsular ligaments and the labral suction seal cooperatively manage distractive stability of the hip. Capsular reconstruction using an iliotibial band (ITB) allograft aims to address capsular insufficiency and iatrogenic instability. However, the extent to which this procedure may restore hip distractive stability after a capsular defect is unknown. Purpose: To evaluate the biomechanical effects of capsular reconstruction on distractive stability of the hip joint. Study Design: Controlled laboratory study. Methods: Eight fresh-frozen cadaveric hip specimens were dissected to the level of the capsule and axially distracted in 3 testing states: intact capsule, partial capsular defect, and capsular reconstruction with an ITB allograft. Each femur was compressed with 500 N of force and then distracted 6 mm relative to the neutral position at 0.5 mm/s. Distractive force was continuously recorded, and the first peak delineating 2 phases of hip distractive stability in the force-displacement curve was analyzed. Results: The median force at maximum distraction in the capsular reconstruction state (156 N) was significantly greater than that in the capsular defect state (89 N; P = .036) but not significantly different from that in the intact state (218 N; P = .054). Median values for distractive force at first peak (60 N, 72 N, and 61 N, respectively; P = .607), distraction at first peak (2.3 mm, 2.3 mm, and 2.5 mm, respectively; P = .846), and percentage decrease in distractive force (35%, 78%, and 63%, respectively; P = .072) after the first peak were not significantly different between the intact, defect, and reconstruction states. Conclusion: Capsular reconstruction with an ITB allograft significantly increased the force required to distract the hip compared with a capsular defect in a cadaveric model. To our knowledge, this is the first study to report an initial peak distractive force and to propose 2 distinct phases of hip distractive stability. Clinical Relevance: The consequences of a capsular defect on distractive stability of the hip may be underappreciated among the orthopaedic community; with that said, capsular reconstruction using an ITB allograft provided significantly increased distractive stability and should be considered an effective treatment option for patients with symptomatic capsular deficiency.

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Dynamic femoral head translations in dysplastic hips

Abstract: 2017-08-25T16:29:20

Cited by 16 publications

References 51 publications

Does Capsular Laxity Lead to Microinstability of the Native Hip?

Does Capsular Laxity Lead to Microinstability of the Native Hip?

Dynamic hip kinematics before and after periacetabular osteotomy in patients with dysplasia

Effects of Capsular Reconstruction With an Iliotibial Band Allograft on Distractive Stability of the Hip Joint: A Biomechanical Study

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