Dynamic femoral head coverage following periacetabular osteotomy for developmental dysplasia of the hip

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-23 DOI:10.1016/j.clinbiomech.2025.106471

Christina A. Bourantas , Emma C. Behrman , Molly C. Shepherd , Keith R. Lohse , John C. Clohisy , Michael D. Harris

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引用次数: 0

Abstract

Background

Developmental dysplasia of the hip reduces hip stability due to insufficient femoral head coverage. Periacetabular osteotomy surgery aims to increase this coverage. Typically measured using radiographs, most coverage assessments are limited to static hip positions and cannot capture 3D anatomy. This study quantified how dynamic 3D femoral coverage changes during gait and squat after periacetabular osteotomy surgery and compared dynamic coverage to static measures.

Methods

Pre- and post-surgery CT scans from 38 patients with hip dysplasia were used to reconstruct 3D femur and pelvis bones with which gait and squat were simulated. Models of 38 control subjects were also created. The femoral head was divided into anteromedial, anterolateral, posteromedial, and posterolateral regions. Regional coverage was compared pre- and post-surgery, and against controls, in a static neutral position, during the stance phase of gait, and throughout the squat cycle.

Findings

Lateral coverage increased post-surgery in the static neutral position (anterolateral: 4.9 ± 3.6 % to 13.8 ± 5.6 %; posterolateral: 22.9 ± 15.4 % to 39.8 ± 15.2 % (p ≤ 0.001)) and throughout gait and squat (p ≤ 0.001). Average changes in neutral anterolateral coverage (+8.9 ± 4.5 %) were similar to average changes during gait (+8.1 ± 3.0 %), but not squat (+12.0 ± 1.9 %). Static neutral coverage post-surgery differed significantly from dynamic coverage in every region of the femoral head during all of gait, and most of squat.

Interpretation

While static measures follow some patterns of dynamic coverage after surgery, they miss important variations that can impact joint loading. Understanding how periacetabular osteotomy changes dynamic femoral head coverage can aid with operative planning and assessment to optimize outcomes during daily activities.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.