Restoring range of motion in reduced acetabular version by increasing femoral antetorsion - What about joint load?
| Autor: | William R. Taylor, Jess G. Snedeker, Florian Schellenberg, Patrick O. Zingg, Reto Sutter, Anna Jungwirth-Weinberger, Stefan Rahm, Jonas Widmer, Tabitha Roth, Janine Süess |
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| Přispěvatelé: | University of Zurich, Zingg, Patrick |
| Rok vydání: | 2021 |
| Předmět: |
musculoskeletal diseases
Joint load Biophysics 610 Medicine & health 03 medical and health sciences Hip joint load 0302 clinical medicine Gait (human) 2732 Orthopedics and Sports Medicine Medicine Humans Orthopedics and Sports Medicine Femur Range of Motion Articular Joint (geology) Femoroacetabular impingement Orthodontics Proximal femur Finite element simulation Acetabular retroversion Femoral antetorsion business.industry Acetabulum 030229 sport sciences medicine.disease musculoskeletal system Hip Joint 10046 Balgrist University Hospital Swiss Spinal Cord Injury Center business Range of motion Tomography X-Ray Computed 030217 neurology & neurosurgery 1304 Biophysics |
| Zdroj: | Clinical Biomechanics, 87 |
| ISSN: | 0268-0033 1879-1271 |
| DOI: | 10.5167/uzh-212413 |
| Popis: | Background Acetabular retroversion results in reduced range of motion, and is thought to contribute to femoroacetabular impingement. Severe retroversion can be corrected with a periacetabular osteotomy, which is a technically demanding intervention. In this study, we investigated whether increasing femoral antetorsion is a potential alternative to restore the range of motion and how this approach would affect hip joint loading. Methods Six different finite element models of the same subject were built from MRI and used to simulate different load scenarios during stance phase, including healthy and pathological configurations with different acetabular version and femoral torsion angles. The subject's gait was analysed in our gait lab and motion data as well as joint reaction forces were integrated into the model. Hip range of motion, hip abductor muscle forces as well as localization and magnitude of hip joint loads were determined. Findings The negative effects of acetabular retroversion on hip range of motion including flexion and internal rotation can be reversed by increasing femoral anteversion. The rotation of the femur furthermore affected muscular functionality by shortening the moment arms of the hip abductor muscles, resulting in increased abductor muscle forces, joint reaction forces and hip joint loading. Interpretation Even though increased femoral antetorsion can compensate for the loss of hip range of motion due to reduced acetabular version, rotational ostotomy of the proximal femur is likely to alter muscular moment arms and therefore increase hip joint load, conflicting the goal of a long-term healthy joint. Clinical Biomechanics, 87 ISSN:0268-0033 ISSN:1879-1271 |
| Databáze: | OpenAIRE |
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