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Mechanobiological prediction of proximal femoral deformities in children with cerebral palsy
Authors:Alessandra Carriero  Ilse Jonkers  Sandra J. Shefelbine
Affiliation:1. Department of Bioengineering , Imperial College , Royal School of Mines, South Kensington Campus, SW7 2AZ, London, UK a.carriero@imperial.ac.uk;3. Department Biomedical Kinesiology , Faculty of Physical Education and Physiotherapy, Research Center for Movement Control and Neuroplasticity, Katholieke Universiteit , Leuven, Belgium;4. Department of Bioengineering , Imperial College , Royal School of Mines, South Kensington Campus, SW7 2AZ, London, UK
Abstract:Children with cerebral palsy (CP) walk with altered gait and frequently exhibit proximal femoral deformities, such as anteversion and coxa valga. The objective of this research was to investigate the effect of specific gait patterns on the femoral morphology in CP.

In this study, the mechanobiological principles were implemented on a 3D finite element (FE) model of the proximal femur in order to predict changes in morphology over time in healthy and CP children. This model relies on the assumption that cyclic octahedral shear stress promotes growth and cyclic hydrostatic compressive stress inhibits growth. Growth was simulated over 16 iterations, representing approximately 5 months of growth.

The FE model predicts an increase in the femoral anteversion and coxa valga for CP loading conditions when compared with healthy ones. Understanding the role of loading in skeletal morphogenesis may help prevent bone deformities and improve function in children with gait abnormalities.
Keywords:mechanobiology  bone growth  cerebral palsy  proximal femur  femoral anteversion  coxa valga
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