Hip Ontogenesis: How Evolution, Genes, and Load History Shape Hip Morphotype and Cartilotype

Hogervorst, Tom; Eilander, Wouter; Fikkers, Joost T.; Meulenbelt, Ingrid

doi:10.1007/s11999-012-2511-4

Cited by 36 publications

(30 citation statements)

References 16 publications

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“…As the patients in the above study were treated before 1940, it is debatable how much relevance these statistics have for patients treated today. However, it has recently been proposed that joint shape is a key determinant in the risk of osteoarthritis (Hogervorst et al, 2012;Sandell, 2012), which may therefore mean that DDH patients in whom an "optimal" joint shape was not achieved (not necessarily equivalent to the treatment aim of a stable joint shape) may be at increased risk of developing osteoarthritis in later life.…”

Section: Nc Nowlanmentioning

confidence: 99%

Biomechanics of foetal movement

Nowlan¹

2015

eCM

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Foetal movements commence at seven weeks of gestation, with the foetal movement repertoire including twitches, whole body movements, stretches, isolated limb movements, breathing movements, head and neck movements, jaw movements (including yawning, sucking and swallowing) and hiccups by ten weeks of gestational age. There are two key biomechanical aspects to gross foetal movements; the first being that the foetus moves in a dynamically changing constrained physical environment in which the freedom to move becomes increasingly restricted with increasing foetal size and decreasing amniotic fluid. Therefore, the mechanical environment experienced by the foetus affects its ability to move freely. Secondly, the mechanical forces induced by foetal movements are crucial for normal skeletal development, as evidenced by a number of conditions and syndromes for which reduced or abnormal foetal movements are implicated, such as developmental dysplasia of the hip, arthrogryposis and foetal akinesia deformation sequence. This review examines both the biomechanical effects of the physical environment on foetal movements through discussion of intrauterine factors, such as space, foetal positioning and volume of amniotic fluid, and the biomechanical role of gross foetal movements in human skeletal development through investigation of the effects of abnormal movement on the bones and joints. This review also highlights computational simulations of foetal movements that attempt to determine the mechanical forces acting on the foetus as it moves. Finally, avenues for future research into foetal movement biomechanics are highlighted, which have potential impact for a diverse range of fields including foetal medicine, musculoskeletal disorders and tissue engineering.Keywords: Foetal movement, fetal movement, bone development, joint development, developmental dysplasia of the hip, arthrogryposis, biomechanical models, computational simulation, mechanical properties of foetal tissues, mechanical properties of fetal tissues.

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Section: Nc Nowlanmentioning

confidence: 99%

Biomechanics of foetal movement

Nowlan¹

2015

eCM

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“…The control subjects with elevated (C 55°) alpha angles also showed a larger mean omega zone of 20% (95% CI, 18-22; p = 0.004) and 16% (95% CI, 13-19; p = 0.007) for 60°and 90°of flexion, respectively, compared with the patients with FAI. Furthermore, the mean omega zone at 0°a nd 30°was larger with 23% (95% CI, 19-27; p = 0.017) and 22% (95% CI, 19-26; p = 0.004), respectively, whereas the mean omega zone in patients with FAI was 18% (95% CI, [15][16][17][18][19][20][21][22] and 16% (95% CI, [11][12][13][14][15][16][17][18][19][20] (Table 3). In contrast, the omega zone was similar in both control groups at any of the flexion positions (0°p = 0.806, 30°p = 0.925, 60°p = 0.345, 90°p = 0.136).…”

Section: Resultsmentioning

confidence: 99%

“…Correspondingly, although the ''overall'' association between hip morphology and OA seems well substantiated [8,11,16], the correlation of isolated femoral or acetabular parameters and OA development is clear only for more extreme values and is in fact weak for values used as cutoffs to distinguish between ''normal'' and ''abnormal'' morphology [1,10,16,20]. For example, the association between OA development and cam morphotype using a cutoff value of 60°for the lateral alpha angle was found robust only for angles above 83°([ 83°: end-stage OA in 14 of 56 cases; 60°-83°end-stage OA in three of 100 cases [1]).…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, we realize morphology alone can never explain the full spectrum of hip symptoms or signs nor whether OA will inevitably develop. Mechanical loading and cartilage characteristics play an important role, including the joint's loading history (frequency and magnitude of all loads across the joint) and ability of cartilage to withstand mechanical stress [8,11,16].…”

Section: Discussionmentioning

confidence: 99%

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Can Combining Femoral and Acetabular Morphology Parameters Improve the Characterization of Femoroacetabular Impingement?

Bouma

Hogervorst

Audenaert

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Femoroacetabular impingement (FAI) presupposes a dynamic interaction of the proximal femur and acetabulum producing clinical symptoms and chondrolabral damage. Currently, FAI classification is based on alpha angle and center-edge angle measurements in a single plane. However, acetabular and femoral version and neck-shaft angle also influence FAI. Furthermore, each of these parameters has a reciprocal interaction with the others; for example, a shallow acetabulum delays impingement of the femoral head with the acetabular rim. Questions/purposes We introduce the new parameter ''omega zone,'' which combines five parameters into one: the alpha and center-edge angles, acetabular and femoral version, and neck-shaft angle. We sought to determine whether the omega zone could differentiate patients with FAI from (1) normal control subjects (alpha \ 55°), but also from (2) control subjects with elevated alpha angles (C 55°). Methods We evaluated CT data of 20 hips of male patients with symptomatic cam-type FAI and of 35 male hips extracted from 110 anonymized CT scans for vascular diagnosis. We excluded hips with osteoarthritis, developmental dysplasia, or coxa profunda (center-edge angle 20°-45°on AP pelvic view or corresponding coronal CT views). With dedicated software, femoral and pelvic orientation was standardized; we tested the omega zone in four hip positions in three distinct groups: patients with cam-type FAI (alpha [ 60°) and control subjects with normal (\ 55°) and high alpha angles (C 55°). Results The omega zone was smaller in patients with cam-type FAI than normal control subjects (alpha angle \ 55°) at 60°and 90°of flexion (mean, 12%; 95% confidence interval [CI], 7-17; p = 0.008; Cohen's d = 9%; 95% CI, 4-13; p = 0.003). Furthermore, the omega zone was smaller in all positions in patients with cam-type FAI than control subjects with high alpha angles (0°p = 0.017, 30°p = 0.004, 60°p = 0.004, 90°p = 0.007). In contrast, the omega zone did not differ between control subjects with normal or high alpha angles. In all hips, the omega zone decreased with flexion, corresponding to a decrease in remaining impingement-free motion with flexion.

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“…There is current evidence that hip pathomorphologies may arise subsequent to genetic factors and to abnormal load pattern or adverse growth events, eg, LCPD or SCFE. Genetic influences most likely are not based on a single gene but are polygenic and complex [6]. Abnormal orientation or shape of the acetabulum as in DDH and acetabular retroversion are not isolated features of the hip itself but are associated with an abnormal orientation and growth of the entire innominate bone [14].…”

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confidence: 99%