TY - JOUR
T1 - The association between periacetabular osteotomy reorientation and hip joint reaction forces in two subgroups of acetabular dysplasia
AU - Gaffney, Brecca M.M.
AU - Clohisy, John C.
AU - Van Dillen, Linda R.
AU - Harris, Michael D.
N1 - Funding Information:
This project was supported by the National Institutes of Health (Grant Numbers: T32HD007434 , K01AR072072 , P30AR074992 , F32AR075349 ), the L’Oréal USA For Women in Science Fellowship, and the Caroline Lottie Hardy Charitable Trust. Additional support was obtained from the Curing Hip Disease Fund (JCC). We thank Jacqueline Foody and Molly Shepherd for their assistance in data processing and segmentation. Appendix A
Funding Information:
This project was supported by the National Institutes of Health (Grant Numbers: T32HD007434, K01AR072072, P30AR074992, F32AR075349), the L'Or?al USA For Women in Science Fellowship, and the Caroline Lottie Hardy Charitable Trust. Additional support was obtained from the Curing Hip Disease Fund (JCC). We thank Jacqueline Foody and Molly Shepherd for their assistance in data processing and segmentation.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2020/1/2
Y1 - 2020/1/2
N2 - Acetabular dysplasia is primarily characterized by an altered acetabular geometry that results in deficient coverage of the femoral head, and is a known cause of hip osteoarthritis. Periacetabular osteotomy (PAO) is a surgical reorientation of the acetabulum to normalize coverage, yet its effect on joint loading is unknown. Our objective was to establish how PAO, simulated with a musculoskeletal model and probabilistic analysis, alters hip joint reaction forces (JRF) in two representative patients of two different acetabular dysplasia subgroups: anterolateral and posterolateral coverage deficiencies. PAO reorientation was simulated within the musculoskeletal model by adding three surgical degrees of freedom to the acetabulum relative to the pelvis (acetabular adduction, acetabular extension, medial translation of the hip joint center). Monte Carlo simulations were performed to generate 2000 unique PAO reorientations for each patient; from which 99% confidence bounds and sensitivity factors were calculated to assess the influence of input variability (PAO reorientation) on output (hip JRF) during gait. Our results indicate that reorientation of the acetabulum alters the lines of action of the hip musculature. Specifically, as the hip joint center was medialized, the moment arm of the hip abductor muscles was increased, which in turn increased the mechanical force-generating capacity of these muscles and decreased joint loading. Independent of subgroup, hip JRF was most sensitive to hip joint center medialization. Results from this study improve understanding of how PAO reorientation affects muscle function differently dependent upon acetabular dysplasia subgrouping and can be used to inform more targeted surgical interventions.
AB - Acetabular dysplasia is primarily characterized by an altered acetabular geometry that results in deficient coverage of the femoral head, and is a known cause of hip osteoarthritis. Periacetabular osteotomy (PAO) is a surgical reorientation of the acetabulum to normalize coverage, yet its effect on joint loading is unknown. Our objective was to establish how PAO, simulated with a musculoskeletal model and probabilistic analysis, alters hip joint reaction forces (JRF) in two representative patients of two different acetabular dysplasia subgroups: anterolateral and posterolateral coverage deficiencies. PAO reorientation was simulated within the musculoskeletal model by adding three surgical degrees of freedom to the acetabulum relative to the pelvis (acetabular adduction, acetabular extension, medial translation of the hip joint center). Monte Carlo simulations were performed to generate 2000 unique PAO reorientations for each patient; from which 99% confidence bounds and sensitivity factors were calculated to assess the influence of input variability (PAO reorientation) on output (hip JRF) during gait. Our results indicate that reorientation of the acetabulum alters the lines of action of the hip musculature. Specifically, as the hip joint center was medialized, the moment arm of the hip abductor muscles was increased, which in turn increased the mechanical force-generating capacity of these muscles and decreased joint loading. Independent of subgroup, hip JRF was most sensitive to hip joint center medialization. Results from this study improve understanding of how PAO reorientation affects muscle function differently dependent upon acetabular dysplasia subgrouping and can be used to inform more targeted surgical interventions.
KW - Acetabular dysplasia
KW - Hip
KW - Joint reaction force
KW - Musculoskeletal modeling
KW - Periacetabular osteotomy
KW - Probabilistic analyses
UR - http://www.scopus.com/inward/record.url?scp=85075348023&partnerID=8YFLogxK
U2 - 10.1016/j.jbiomech.2019.109464
DO - 10.1016/j.jbiomech.2019.109464
M3 - Article
C2 - 31708245
AN - SCOPUS:85075348023
VL - 98
JO - Journal of Biomechanics
JF - Journal of Biomechanics
SN - 0021-9290
M1 - 109464
ER -