Changes in walking and running in patients with hip dysplasia

Jacobsen, Julie Sandell; Nielsen, Dennis Brandborg; Sørensen, Henrik Toft; Søballe, Kjeld; Mechlenburg, Inger

doi:10.3109/17453674.2013.792030

Cited by 32 publications

(53 citation statements)

References 25 publications

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“…Some prior studies reported a marked decrease in peak hip extension in patients, which was not a finding with our cohort (Jacobsen et al, 2013; Romano et al, 1996; Skalshoi et al, 2015). It has been postulated that reduced hip extension is a pain avoidance mechanism to reduce anterior joint loading (Skalshoi et al, 2015).…”

Section: Discussioncontrasting

confidence: 96%

“…Results from these studies support the concept that dysplasia alters hip kinematics and kinetics during gait, but data have been contradictory. For example, Romano et al (1996) and Jacobsen et al (2013) found lower peak hip extension during stance in patients with dysplasia, whereas Pederson et al (2004) found no significant differences in hip extension during stance.…”

Section: Introductionmentioning

confidence: 95%

“…Studies of gait in dysplasia patients include comparisons to the presumed healthy contralateral limb (Romano et al, 1996), a control group (Jacobsen et al, 2013; Pedersen et al, 2004; Romano et al, 1996; Skalshoi et al, 2015), or locomotion before and after corrective surgery (Endo et al, 2003; Pedersen et al, 2006). These studies have varied somewhat in their analysis techniques and the dependent variables of interest, but typically use marker-based motion capture to analyze joint kinematics and kinetics for young adults (mean ages 34–48).…”

Section: Introductionmentioning

confidence: 99%

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Higher medially-directed joint reaction forces are a characteristic of dysplastic hips: A comparative study using subject-specific musculoskeletal models

Harris

MacWilliams

Foreman

et al. 2017

Journal of Biomechanics

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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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Section: Discussioncontrasting

confidence: 96%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Higher medially-directed joint reaction forces are a characteristic of dysplastic hips: A comparative study using subject-specific musculoskeletal models

Harris

MacWilliams

Foreman

et al. 2017

Journal of Biomechanics

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“…Similarly, identical kinematics were used for both subject groups. In previous studies, dysplastic patients exhibited subtle alternations in kinematics during gait, including increased pelvic drop, increased pelvic rotation, reduced hip extension and a reduction in ground reaction force in comparison to normal hips [49, 50]. Increased pelvic drop may cause increased labral loading, while increased pelvic rotation may shift contact patterns posteriorly.…”

Section: Discussionmentioning

confidence: 99%

Patient-specific analysis of cartilage and labrum mechanics in human hips with acetabular dysplasia

Henak

Abraham

Anderson

et al. 2014

Osteoarthritis and Cartilage

142

128

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BACKGROUND Acetabular dysplasia is a major predisposing factor for development of hip osteoarthritis, and may result from alterations to chondrolabral loading. Subject-specific finite element (FE) modeling can be used to evaluate chondrolabral mechanics in the dysplastic hip, thereby providing insight into mechanics that precede osteoarthritis. OBJECTIVE To evaluate chondrolabral contact mechanics and congruency in dysplastic hips and normal hips using a validated approach to subject-specific FE modeling. METHODS FE models of ten subjects with normal acetabula and ten subjects with dysplasia were constructed using a previously validated protocol. Labrum load support, and labrum and acetabular cartilage contact stress and contact area were compared between groups. Local congruency was determined at the articular surface for two simulated activities. RESULTS The labrum in dysplastic hips supported 2.8 to 4.0 times more of the load transferred across the joint than in normal hips. Dysplastic hips did not have significantly different congruency in the primary load-bearing regions than normal hips, but were less congruent in some unloaded regions. Normal hips had larger cartilage contact stress than dysplastic hips in the few regions that had significant differences. CONCLUSIONS The labrum in dysplastic hips has a far more significant role in hip mechanics than it does in normal hips. The dysplastic hip is neither less congruent than the normal hip, nor subjected to elevated cartilage contact stresses. This study supports the concept of an outside-in pathogenesis of osteoarthritis in dysplastic hips and that the labrum in dysplastic hips should be preserved during surgery.

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“…Transsartorial periacetabular osteotomy (PAO) [24] is performed in young patients with hip dysplasia to relieve hip pain and increase hip-related physical function [5,6]. Use of PAO may help postpone or prevent hip osteoarthritis (OA), but to our knowledge, no studies randomizing patients to either PAO or conservative treatment have been done, therefore we do not know whether PAO directly affects the development or progression of OA in patients with hip dysplasia.…”

Section: Introductionmentioning

confidence: 99%

Cartilage Thickness and Cyst Volume Are Unchanged 10 Years After Periacetabular Osteotomy in Patients Without Hip Symptoms

Mechlenburg

Nyengaard

Gelineck

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Periacetabular osteotomy (PAO) may affect cartilage thickness and cyst volume in patients with hip dysplasia. However, as no studies randomizing patients to either PAO or conservative treatment have been performed, to our knowledge, it is unknown if PAO directly affects the development or progression of osteoarthritis in patients with hip dysplasia. Questions/purposes We investigated (1) changes of cartilage thickness in the hip after PAO; (2) how many patients had subchondral bone cysts in the acetabulum or femoral head; (3) changes in cyst volume; and (4) patients' hip function and pain after PAO. Patients and Methods In this prospective study, 26 patients (22 women and four men) with hip dysplasia were enrolled with the goal of having MRI of the hip before undergoing PAO and again at 1, 2 1 .2, and 10 years after PAO. Of the 26 patients, 17 (65%) underwent complete followup 10 years after PAO, whereas nine could not be included. Of those nine, three had undergone THA, three had substantial hip symptoms, and three were lost to followup. Thickness of acetabular and femoral cartilage and volume of subchondral bone cysts were estimated in the remaining 17 patients. Ten years postoperatively, the patients' Hip disability and Osteoarthritis Outcome Scores (HOOS) were collected. Results Preoperatively, the mean thickness of the acetabular cartilage was 1.38 ± 0.14 mm compared with 1.43 ± 0.07 mm 10 years postoperatively (p = 0.73). The mean thickness of the femoral cartilage preoperatively was 1.37 ± 0.20 mm compared with 1.30 ± 0.07 mm 10 years postoperatively (p = 0.24). Seven patients had an increase in cyst volume, six had a decrease, and four had no cysts to start with and remained without cysts. Preoperatively, the median total cyst volume per patient was 6.0 cm 3 (range, 1.6-188.3 cm 3 ) compared with 2.9 cm 3 (range, 0.7-8.2 cm 3 ) (p = 0.18) at 10 years followup. At 10 years, the mean subscores for the HOOS were: pain, 79 ± 16;

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Changes in walking and running in patients with hip dysplasia

Cited by 32 publications

References 25 publications

Higher medially-directed joint reaction forces are a characteristic of dysplastic hips: A comparative study using subject-specific musculoskeletal models

Higher medially-directed joint reaction forces are a characteristic of dysplastic hips: A comparative study using subject-specific musculoskeletal models

Patient-specific analysis of cartilage and labrum mechanics in human hips with acetabular dysplasia

Cartilage Thickness and Cyst Volume Are Unchanged 10 Years After Periacetabular Osteotomy in Patients Without Hip Symptoms

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