ESMAC Best Paper Award 2023: Increased knee flexion in participants with cerebral palsy results in altered stresses at the distal femoral growth plate compared to a typically developing cohort.

Autor: Koller W; Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria; Neuromechanics Research Group, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria; Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, Vienna, Austria. Electronic address: willi.koller@univie.ac.at., Wallnöfer E; Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria; Neuromechanics Research Group, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria., Holder J; Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria., Kranzl A; Laboratory for Gait and Human Movements, Orthopaedic Hospital Speising, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria., Mindler G; Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, Vienna, Austria; Vienna Bone and Growth Center, Vienna, Austria., Baca A; Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria., Kainz H; Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria; Neuromechanics Research Group, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2024 Sep; Vol. 113, pp. 158-166. Date of Electronic Publication: 2024 Jun 18.
DOI: 10.1016/j.gaitpost.2024.06.012
Abstrakt: Introduction: Femoral deformities are highly prevalent in children with cerebral palsy (CP) and can have a severe impact on patients' gait abilities. While the mechanical stress regime within the distal femoral growth plate remains underexplored, understanding it is crucial given bone's adaptive response to mechanical stimuli. We quantified stresses at the distal femoral growth plate to deepen our understanding of the relationship between healthy and pathological gait patterns, internal loading, and femoral growth patterns.
Methods: This study included three-dimensional motion capture data and magnetic resonance images of 13 typically developing children and twelve participants with cerebral palsy. Employing a multi-scale mechanobiological approach, integrating musculoskeletal simulations and subject-specific finite element analysis, we investigated the orientation of the distal femoral growth plate and the stresses within it. Limbs of participants with CP were grouped depending on their knee flexion kinematics during stance phase as this potentially changes the stresses induced by knee and patellofemoral joint contact forces.
Results: Despite similar growth plate orientation across groups, significant differences were observed in the shape and distribution of growth values. Higher growth rates were noted in the anterior compartment in CP limbs with high knee flexion while CP limbs with normal knee flexion showed high similarity to the group of healthy participants.
Discussion: Results indicate that the knee flexion angle during the stance phase is of high relevance for typical bone growth at the distal femur. The evaluated growth rates reveal plausible results, as long-term promoted growth in the anterior compartment leads to anterior bending of the femur which was confirmed for the group with high knee flexion through analyses of the femoral geometry. The framework for these multi-scale simulations has been made accessible on GitHub, empowering peers to conduct similar mechanobiological studies. Advancing our understanding of femoral bone development could ultimately support clinical decision-making.
Competing Interests: Declaration of Competing Interest We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. We, further, confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: