Combining acetabular and femoral morphology improves our understanding of the down syndrome hip

Abstract

Subjects with Down syndrome were found to have a significantly altered and more heterogeneous anatomy of their proximal hips compared to controls. This heterogeneity suggests that treatment strategies of hip instability in Down syndrome should be subject-specific and should rely on the understanding of the underlying three-dimensional anatomy of each patient.

Finite element modeling to compare craniocervical motion in two age-matched pediatric patients without or with Down syndrome: implications for the role of bony geometry in craniocervical junction instability

“…Muscle hypotonia is well described in DS and has even been implicated in the development of instability of other joints in DS patients, such as the hip and knee. 9,10,12,13 Furthermore, the aforementioned collagen type VI genes are implicated in the pathobiology of this hypotonia. 36,38 Before evaluation of differences between the DS model and the age-matched control, it was important to establish the similar behavior of the age-matched control FEM to previous pediatric FEMs and to the behavior of cadaveric specimens.…”

“…Further research supporting the concept of a nonligamentous cause of abnormal joint motion in DS, such as muscle hypotonia or bone/cartilaginous morphology, has been published in the orthopedic literature. [9][10][11][12][13] The study of pediatric spinal biomechanics is challenging, mainly because biomechanical testing primarily relies on cadavers and the number of pediatric cadavers is limited. [14][15][16] As a result, the number of pediatric biomechanical studies in the medical literature is low, but the rise of computational modeling in biomechanical research has changed that.…”