TY - JOUR
T1 - Elevated loading at the posterior acetabular edge of dysplastic hips during double-legged squat
AU - Song, Ke
AU - Pascual-Garrido, Cecilia
AU - Clohisy, John C.
AU - Harris, Michael
N1 - Funding Information:
This project was funded by the National Institutes of Health K01 AR072072, P30 AR074992 and the Lottie Caroline Charitable Trust. The authors thank Molly Shepherd, Lauren Westen, Abby Matt, and Spencer Williams for assistance with image and motion data processing.
Publisher Copyright:
© 2022 Orthopaedic Research Society. Published by Wiley Periodicals LLC.
PY - 2022/9
Y1 - 2022/9
N2 - Hips with developmental dysplasia (DDH) are at a heightened risk of premature hip osteoarthritis, which is often expedited by mechanically induced articular tissue damage. A prevalent form of damage in DDH is labral tears caused by abnormal loading at the shallow acetabular edge. Although the majority of reported DDH-related labral tears occur in the antero-superior acetabulum, posterior labral tears are prevalent in individuals whose lifestyle involves frequent high hip flexion tasks such as squatting. To better understand region-specific risks for chondrolabral damage during high hip flexion, we used image-based musculoskeletal models to compare acetabular edge loading (AEL) during double-legged squat between hips with symptomatic DDH (n = 10) and healthy controls (n = 10). Compared to controls, hips with DDH had higher instantaneous posterior AEL at the lowest point of squat (2.6 vs. 1.8 ×BW, p ≤ 0.04), and higher accumulative loading across the duration of the squatting motion (2.6 vs. 1.9 ×BW*s, p ≤ 0.04). Elevated posterior AEL coincided with increased net hip extension moments and posterior joint reaction forces, and was correlated with the severity of DDH acetabular deformity. Our findings suggest that posterior AEL is elevated in hips with symptomatic DDH during double-legged squat, which may contribute to chondrolabral damage in individuals who often perform such high hip flexion tasks. Clinical evaluation of DDH should consider patient-specific anatomy and lifestyle factors when establishing diagnoses and planning personalized treatment.
AB - Hips with developmental dysplasia (DDH) are at a heightened risk of premature hip osteoarthritis, which is often expedited by mechanically induced articular tissue damage. A prevalent form of damage in DDH is labral tears caused by abnormal loading at the shallow acetabular edge. Although the majority of reported DDH-related labral tears occur in the antero-superior acetabulum, posterior labral tears are prevalent in individuals whose lifestyle involves frequent high hip flexion tasks such as squatting. To better understand region-specific risks for chondrolabral damage during high hip flexion, we used image-based musculoskeletal models to compare acetabular edge loading (AEL) during double-legged squat between hips with symptomatic DDH (n = 10) and healthy controls (n = 10). Compared to controls, hips with DDH had higher instantaneous posterior AEL at the lowest point of squat (2.6 vs. 1.8 ×BW, p ≤ 0.04), and higher accumulative loading across the duration of the squatting motion (2.6 vs. 1.9 ×BW*s, p ≤ 0.04). Elevated posterior AEL coincided with increased net hip extension moments and posterior joint reaction forces, and was correlated with the severity of DDH acetabular deformity. Our findings suggest that posterior AEL is elevated in hips with symptomatic DDH during double-legged squat, which may contribute to chondrolabral damage in individuals who often perform such high hip flexion tasks. Clinical evaluation of DDH should consider patient-specific anatomy and lifestyle factors when establishing diagnoses and planning personalized treatment.
KW - developmental dysplasia of the hip
KW - edge loading
KW - labral tears
KW - musculoskeletal modeling
KW - squat
UR - http://www.scopus.com/inward/record.url?scp=85122682686&partnerID=8YFLogxK
U2 - 10.1002/jor.25249
DO - 10.1002/jor.25249
M3 - Article
C2 - 35015910
AN - SCOPUS:85122682686
SN - 0736-0266
VL - 40
SP - 2147
EP - 2155
JO - Journal of Orthopaedic Research
JF - Journal of Orthopaedic Research
IS - 9
ER -