Higher medially-directed joint reaction forces are a characteristic of dysplastic hips: A comparative study using subject-specific musculoskeletal models |
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| Institution: | 1. Program in Physical Therapy, Washington University School of Medicine, St Louis, MO 63108, United States;2. Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO 63108, United States;3. Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, United States;4. Shriners Hospitals for Children, Salt Lake City, UT 84103, United States;5. Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, United States;6. Department of Physical Therapy, University of Utah, Salt Lake City, UT 84108, United States;7. Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, United States;1. Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USA;2. Department of Mechanical Engineering, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USA;3. Pediatric Orthopedic Surgery, Arnold Palmer Hospital and International Hip Dysplasia Institute (IHDI), Orlando, FL 32806, USA;4. College of Medicine, University of Central Florida, Orlando, FL 32827, USA;1. Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, USA;2. School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA;3. Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA;1. Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan;2. Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-0004, Japan;3. Department of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-0004, Japan;4. Department of Creative Engineering, National Institute of Technology, Kitakyushu College, 5-20-1 Shii, Kokuraminami-ku, Kitakyushu, Fukuoka, 802-0985 Japan;1. Department of Information Engineering, University of Padova, Via Gradenigo 6b I, 35131 Padova, Italy;2. Department of Kinesiology, KU Leuven, Tervuursevest 101 - Box 1501, 3001, Leuven, Belgium;3. Department of Clinical Medicine and Metabolic Disease, University Polyclinic, Via Giustiniani 2, Padova, Italy;1. Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia;2. Department of Neurorehabilitation Engineering, University Medical Center Göttingen, Georg-August University, Göttingen, Germany;3. Department of Management and Engineering, University of Padua, Vicenza, Italy;4. Auckland Bioengineering Institute & Dept of Engineering Science, University of Auckland, Auckland, New Zealand;5. Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL, USA;1. Hugh Williamson Gait Analysis Laboratory, The Royal Children’s Hospital, Australia;2. Gait Lab & Orthopaedics, Murdoch Children’s Research Institute, Australia;3. The University of Melbourne, Department of Mechanical Engineering, Australia;4. The University of Melbourne, Department of Paediatrics, Australia |
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| Abstract: | Acetabular dysplasia is a known cause of hip osteoarthritis. In addition to abnormal anatomy, changes in kinematics, joint reaction forces (JRFs), and muscle forces could cause tissue damage to the cartilage and labrum, and may contribute to pain and fatigue. The objective of this study was to compare lower extremity joint angles, moments, hip JRFs and muscle forces during gait between patients with symptomatic acetabular dysplasia and healthy controls. Marker trajectories and ground reaction forces were measured in 10 dysplasia patients and 10 typically developing control subjects. A musculoskeletal model was scaled in OpenSim to each subject and subject-specific hip joint centers were determined using reconstructions from CT images. Joint kinematics and moments were calculated using inverse kinematics and inverse dynamics, respectively. Muscle forces and hip JRFs were estimated with static optimization. Inter-group differences were tested for statistical significance (p ≤ 0.05) and large effect sizes (d ≥ 0.8). Results demonstrated that dysplasia patients had higher medially directed JRFs. Joint angles and moments were mostly similar between the groups, but large inter-group effect sizes suggested some restriction in range of motion by patients at the hip and ankle. Higher medially-directed JRFs and inter-group differences in hip muscle forces likely stem from lateralization of the hip joint center in dysplastic patients. Joint force differences, combined with reductions in range of motion at the hip and ankle may also indicate compensatory strategies by patients with dysplasia to maintain joint stability. |
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| Keywords: | Biomechanics Hip Acetabular dysplasia Gait Musculoskeletal modeling |
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